3D打印技术在复杂胫骨平台骨折临床诊治中的应用
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摘要
目的探讨三维(3D)打印技术在复杂胫骨平台骨折患者诊断与治疗中的临床效果。方法采用前瞻性研究方法,选取2014年8月至2017年12月沧州市人民医院医专院区骨科收治的80例复杂胫骨平台骨折患者,以简单化随机分组法随机分为观察组与对照组,每组各40例,分别选择3D打印技术与常规手术治疗,比较两组患者术后12个月时美国特种外科医院(HSS)评分、手术指标及相关并发症情况。结果观察组患者的手术解剖复位率为90. 0%(36/40),对照组患者手术解剖结构复位率为65. 0%(26/40);观察组患者解剖结构复位率明显高于对照组(χ~2=17. 921,P=0. 000)。术后12个月观察组患者HSS评分为(89. 74±10. 33)分,对照组患者HSS评分为(83. 64±11. 58)分,观察组患者HSS评分明显高于对照组(t=2. 486,P=0. 015)。与对照组相比,观察组患者的手术时间明显缩短,术中出血量明显减少(P <0. 05);两组患者的住院时间、骨折愈合时间、完全负重时间相比,差异无统计学意义(P> 0. 05)。观察组与对照组患者并发症发生率相比,差异无统计学意义(χ~2=2. 485,P=0. 127)。结论 3D打印技术能够有效改善复杂胫骨平台骨折的临床疗效,缩短手术治疗时间、减少出血量,提高复位的效果,促进膝关节的功能恢复,临床效果较好。
Objective To explore the clinical effect of 3D printing technique in diagnosis and treatment of complex tibia plateau fractures.Methods Eighty patients with complex tibial plateau fracture in this hospital were randomly divided into observation group and control group by simple random grouping method. 40 patients in each group,they were treated by 3D printing technique and routine operation respectively. The following 12 months,the hospital for special surgery( HSS) scores,surgical indicators and related complications were observed and compared between these 2 groups. Results The operative anatomical reduction rate of observation group was 90. 0%( 36/40),and that of control group was 65. 0%( 26/40),and that of observation group was significantly higher than that of control group( χ~2= 17. 921,P = 0. 000). In 12 months after the operation,HSS scores of observation group were( 89. 74 ± 10. 33). The HSS scores of control group were( 83. 64 ± 11. 58). The HSS scores of observation group were significantly higher than those of control group( t = 2. 486,P = 0. 015). In comparison with control group,the operating time of observation group was significantly shortened,and the amount of bleeding during operation was significantly reduced( P < 0. 05).There was no significant difference between these two groups in hospitalization time,fracture healing time and full weight-bearing time( P >0. 05). There was no significant difference in incidence of complications between observation group and control group( χ~2= 2. 485,P = 0. 127).Conclusion 3D printing technique can effectively improve the clinical effect of complex tibial plateau fracture,shorten the time of surgical treatment,reduce the amount of bleeding,improve the effect of reduction,and promote the functional recovery of knee joint.
Objective To explore the clinical effect of 3D printing technique in diagnosis and treatment of complex tibia plateau fractures.Methods Eighty patients with complex tibial plateau fracture in this hospital were randomly divided into observation group and control group by simple random grouping method. 40 patients in each group,they were treated by 3D printing technique and routine operation respectively. The following 12 months,the hospital for special surgery( HSS) scores,surgical indicators and related complications were observed and compared between these 2 groups. Results The operative anatomical reduction rate of observation group was 90. 0%( 36/40),and that of control group was 65. 0%( 26/40),and that of observation group was significantly higher than that of control group( χ~2= 17. 921,P = 0. 000). In 12 months after the operation,HSS scores of observation group were( 89. 74 ± 10. 33). The HSS scores of control group were( 83. 64 ± 11. 58). The HSS scores of observation group were significantly higher than those of control group( t = 2. 486,P = 0. 015). In comparison with control group,the operating time of observation group was significantly shortened,and the amount of bleeding during operation was significantly reduced( P < 0. 05).There was no significant difference between these two groups in hospitalization time,fracture healing time and full weight-bearing time( P >0. 05). There was no significant difference in incidence of complications between observation group and control group( χ~2= 2. 485,P = 0. 127).Conclusion 3D printing technique can effectively improve the clinical effect of complex tibial plateau fracture,shorten the time of surgical treatment,reduce the amount of bleeding,improve the effect of reduction,and promote the functional recovery of knee joint.
引文
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[8]何志勇,张擎柱,林影影,等.3D打印技术在复杂胫骨平台骨折手术中应用的可行性研究[J].承德医学院学报,2016,33(4):280-282.
[9]刘超,徐亚非,唐理英,等.3D打印技术在复杂胫骨平台骨折手术中的临床应用效果观察[J].中国临床新医学,2016,9(5):400-403.
[10]杨镇铿,皮佑辉,卢成海,等.基于3D打印技术的复杂胫骨平台骨折内固定手术数字化设计分析[J].吉林医学,2016,37(7):1746-1747.
[2]左睿,孙永建,吴毅,等.3D打印与虚拟手术设计在复杂胫骨平台骨折手术治疗中的应用[J].中国骨与关节损伤杂志,2016,31(4):369-372.
[3]Kladny B,Albrecht C,Haase I,et al.Outcome of inpatient rehabilitation following total knee replacement using the HSS-Score[J].Z Orthop Ihre Grenzgeb,2002,140(1):37-41.
[4]张铁山,陈杰,梁卫东,等.漂浮体位下三柱内固定治疗复杂胫骨平台骨折的临床疗效[J].临床和实验医学杂志,2017,16(23):2315-2318..
[5]张勇,陈敬煌,卢光辉,等.手术治疗复杂胫骨平台骨折27例疗效观察[J].中国骨与关节损伤杂志,2015,30(4):421-422.
[6]吴云峰,尹勇,黄斐,等.3D打印技术在复杂胫骨平台骨折临床诊治中的应用[J].中华解剖与临床杂志,2015,20(4):347-349.
[7]张永飞,李仁增,段德胜,等.3D打印技术在复杂胫骨平台骨折治疗中的应用[J].中国骨与关节损伤杂志,2015,30(12):1321-1322.
[8]何志勇,张擎柱,林影影,等.3D打印技术在复杂胫骨平台骨折手术中应用的可行性研究[J].承德医学院学报,2016,33(4):280-282.
[9]刘超,徐亚非,唐理英,等.3D打印技术在复杂胫骨平台骨折手术中的临床应用效果观察[J].中国临床新医学,2016,9(5):400-403.
[10]杨镇铿,皮佑辉,卢成海,等.基于3D打印技术的复杂胫骨平台骨折内固定手术数字化设计分析[J].吉林医学,2016,37(7):1746-1747.