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【medical-news】怀孕患者髋臼骨折的手术固定

Operative fixation of acetabular fractures in the pregnant patient

Porter SE, Russell GV, Qin Z, Graves ML.
J Orthop. 2008 Sep;22:508-16.
http://www.ncbi.nlm.nih.gov/pubmed/18758280?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

OBJECTIVE: To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair.

DESIGN: Retrospective case series.

SETTING: University-affiliated regional trauma center.

PATIENT/PARTICIPANTS: Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an additional 518 acetabular fractures in nonpregnant patients treated during the same time period.

INTERVENTION: Open reduction and internal fixation of the acetabulum fracture.

OUTCOME MEASUREMENTS: None. This is a descriptive series reporting fetal radiation doses, fetal fluoroscopy exposure times, and fetal viability after treatment.

RESULTS: The gestational age of the fetuses at presentation ranged from 5 to 26 weeks. Infant delivery averaged 27 weeks from the time of surgery and all pregnancies reached 36 weeks. Apgar scores were normal each child including 1 twin delivery. There were 4 posterior wall fractures, 3 transverse or posterior wall fractures, and 1 posterior column fracture. Intraoperative pelvic fluoroscopy averaged 39 seconds. There were no operative complications and fracture reductions were anatomic in 7 patients. Computed tomography scan of the pelvis conferred the greatest exposure risk to the fetus and fluoroscopy conferred the least. In each case that required a computed tomography scan of the pelvis, the calculated radiation exposure dose to the fetus was greater than 5 cGy.

CONCLUSIONS: The results of this study demonstrate that with a team approach and the judicious use of radiographic imaging during the surgical care of a displaced acetabular fracture in the pregnant patient, minimal risk to the baby can be achieved in pursuit of acceptable articular reductions.

本人已认领该文编译,48小时后若未提交译文,请其他战友自由认领。 Operative Fixation of Acetabular Fractures in the Pregnant Patient.
怀孕患者髋臼骨折的手术固定

Abstract:
摘要

Objective: To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair.
目的:描述怀孕患者行髋臼骨折修复时宫内放射学结果。

Design: Retrospective case series.
设计:回顾性病例分析。

Setting: University-affiliated regional trauma center.
机构:大学附属地区创伤中心。

Patient/Participants: Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an additional 518 acetabular fractures in nonpregnant patients treated during the same time period.
患者/参与者:在6年时间里8位怀孕患者因髋臼骨折接受治疗,同期518位非怀孕髋臼骨折患者接受治疗。

Intervention: Open reduction and internal fixation of the acetabulum fracture.
干预措施:针对髋臼骨折行切开复位内固定。

Outcome Measurements: None. This is a descriptive series reporting fetal radiation doses, fetal fluoroscopy exposure times, and fetal viability after treatment.
结果评价:无。本研究旨在描述胎儿的辐射剂量、 X线曝光时间和术后活力。

Results: The gestational age of the fetuses at presentation ranged from 5 to 26 weeks. Infant delivery averaged 27 weeks from the time of surgery and all pregnancies reached 36 weeks. Apgar scores were normal each child including 1 twin delivery. There were 4 posterior wall fractures, 3 transverse or posterior wall fractures, and 1 posterior column fracture. Intraoperative pelvic fluoroscopy averaged 39 seconds. There were no operative complications and fracture reductions were anatomic in 7 patients. Computed tomography scan of the pelvis conferred the greatest exposure risk to the fetus and fluoroscopy conferred the least. In each case that required a computed tomography scan of the pelvis, the calculated radiation exposure dose to the fetus was greater than 5 cGy.
结果:手术时胎龄范围为5周至26周。婴儿在术后平均27周后分娩,所有妊娠达到36周。包括一对双胞胎在内的每个婴儿阿普加评分均正常。患者中4例后壁骨折,3例横向合并后壁骨折,以及1例后柱骨折。术中骨盆透视平均时间为39秒。未见手术并发症,7位患者骨折达到解剖复位。骨盆CT扫描对于胎儿的辐射风险最大,而透视最小。每个需要骨盆CT扫描的患者,其胎儿接受的放射剂量经计算大于5 cGy。

Conclusions: The results of this study demonstrate that with a team approach and the judicious use of radiographic imaging during the surgical care of a displaced acetabular fracture in the pregnant patient, minimal risk to the baby can be achieved in pursuit of acceptable articular reductions.

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作者:admin@医学,生命科学    2010-09-27 17:11
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