Stoppa入路手术治疗骨盆前环骨折合并后尿道断裂

doi:10.6040/j.issn.1671-7554.0.2016.210

山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (8): 88-91.doi: 10.6040/j.issn.1671-7554.0.2016.210

Stoppa入路手术治疗骨盆前环骨折合并后尿道断裂

刘华水,段升军,刘士懂,贾堂宏,贾逢爽

济南市第三人民医院创伤外科, 山东济南 250113

收稿日期:2016-03-02 出版日期:2016-08-10 发布日期:2016-08-10
通讯作者: 贾堂宏. E-mail:jnsylhs2008@163.com E-mail:jnsylhs2008@163.com

Stoppa approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption

LIU Huashui, DUAN Shengjun, LIU Shidong, JIA Tanghong, JIA Fengshuang

Department of Traumatology, Third Peoples Hospital of Jinan, Jinan 250113, Shandong, China

Received:2016-03-02 Online:2016-08-10 Published:2016-08-10

摘要/Abstract

摘要： 目的探讨Stoppa入路手术Ⅰ期治疗骨盆前环骨折合并后尿道断裂的可行性和疗效。方法选取2012年1月至2015年7月采用Stoppa入路手术治疗骨盆前环骨折合并后尿道断裂患者16例。均急诊Ⅰ期行尿道会师牵引、尿道会师吻合或部分吻合,骨盆骨折重建钢板内固定术。术后随访6~36个月,应用Tometta评估和Majeed评分评价骨折复位和术后功能情况。根据临床检查及患者的主观感受评价尿道修复效果。结果手术部位平均切口长度12 cm,手术平均时间136 min。骨折复位Tometta评估:优11例,良3例,可2例。术后功能Majeed评分:优12例,良3例,可1例。尿管拔除后,12例排尿通畅,最大尿流率平均18.5 mL/s;4例出现不同程度的尿道狭窄,6例阴茎勃起困难,2例尿失禁发生。结论 Stoppa入路手术视野清晰,操作安全,可Ⅰ期直视下实现对尿道断裂修复并骨盆前环骨折的复位和固定,是治疗骨盆前环骨折合并后尿道断裂理想入路。

关键词: 尿道断裂, 骨盆骨折, Stoppa入路, 骨折固定术

Abstract: Objective To evaluate the feasibility and efficacy of Stoppa approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption. Methods Clinical data of 16 cases of anterior pelvic ring fractures complicated with posterior disruption during January 2012 and July 2015 were retrospectively analyzed. All patients were treated with emergency operation with the Stoppa approach of open reduction and internal fixation of the pelvis combined with urethral realignment by traction and primary urethra suturing or partial suturing. All patients were followed up for 6 to 36 months. The reduction of fracture and recovery of function were evaluated with Tometta and Majeed score. The urethral repair effect was evaluated with postoperative clinical examination and patients subjective feelings. Results The mean length of incision was 12 cm. The average operation time was 136 min. According to the Tometta score classification, the results were excellent in 11 cases, good in 3 cases, and fair in 2 cases. According to the Majeed score classification, the results were excellent in 12 cases, good in 3 cases, and fair in 1 case. After the urinary catheter was removed, 12 patients achieved good urination, with the mean maximal urine flow being 18.5 mL/s; 4 patients developed dysuria; 6 patients had penile erectile difficulties; and 2 patients had urinary incontinence. Conclusion The Stoppa approach is a safe approach, which can provide clear surgical field to repair the urethral disruption and fix the anterior pelvic ring fractures. It can be an ideal approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption.

Key words: Fracture fixation, Pelvic fractures, Posterior urethral disruption, Stoppa approach

中图分类号:

R615

刘华水,段升军,刘士懂,贾堂宏,贾逢爽. Stoppa入路手术治疗骨盆前环骨折合并后尿道断裂[J]. 山东大学学报（医学版）, 2016, 54(8): 88-91.

LIU Huashui, DUAN Shengjun, LIU Shidong, JIA Tanghong, JIA Fengshuang. Stoppa approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(8): 88-91.

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Stoppa入路手术治疗骨盆前环骨折合并后尿道断裂

Stoppa approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption

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