不同年资足踝外科医师应用3D打印技术治疗足踝骨折效果的比较  

Treatment outcomes of three-dimensional printing technology for foot and ankle fractures by junior versus senior physicians

作　　者：朱亚会 付炳金[1] 尹刚[1] 王超[2] 孙广超[1] 邓明明 杜瑞[1] 杨佳林 朱晓东[1] Zhu Ya-hui;Fu Bing-jin;Yin Gang;Wang Chao;Sun Guang-chao;Deng Ming-ming;Du Rui;Yang Jia-lin;Zhu Xiao-dong(Department of Foot and Ankle Surgery;Department of Neurosurgery,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,Shandong Province,China)

机构地区：[1]滨州医学院附属医院足踝外科,山东省滨州市256603 [2]滨州医学院附属医院神经外科,山东省滨州市256603

出　　处：《中国组织工程研究》2018年第19期3061-3066,共6页Chinese Journal of Tissue Engineering Research

基　　金：山东省自然科学基金(ZR2017LH033);课题名称:支架辅助弹簧圈栓塞对基底动脉顶端动脉瘤血流动力学~~

摘　　要：背景:3D打印技术在足踝外科中的应用越来越广泛,且取得良好效果,但此技术对足踝外科不同年资医师的影响有无差异尚且未知。目的:分析3D打印技术对不同年资足踝外科医师的影响有无差异。方法:滨州医学院附属医院2015年1月至2017年2月收治的足踝部骨折患者随机采用传统手术及3D打印技术辅助手术2种方式,分别由低年资医师和高年资医师完成,分为低年资传统组、低年资3D组、高年资传统组和高年资3D组。记录并对比分析各组患者的手术时间、术中出血量、术中透视次数、术后并发症及末次随访美国足踝骨科协会踝与后足评分。结果与结论:(1)符合标准的89例患者纳入研究,其中29例由于各种原因失访,剩下的60例患者获得完整随访记录,所有患者骨折均在术后3个月愈合;(2)低年资3D组在治疗跟骨骨折及三踝骨折方面,其手术时间、术中出血量、术中透视次数优于低年资传统组,差异有显著性意义(P<0.05);(3)高年资3D组跟骨骨折、跖骨骨折、三踝骨折患者围手术时间、术中出血量、术中透视次数与高年资传统组相比,差异无显著性意义;(4)共有3例患者发生切口感染,低年资3D组和高年资传统组各1例为浅表组织感染;低年资传统组1例为深部感染;(5)末次随访美国足踝骨科协会踝与后足评分,低年资2组间差异无显著性意义,高年资2组间差异亦无显著性意义(P>0.05);(6)表明3D打印技术在手术时间、术中出血量、术中透视次数方面对低年资医师的影响大于高年资医师,在并发症和功能恢复方面对不同年资医师影响差异较小。BACKGROUND： Three-dimensional（3D） printing technology has been extensively applied in foot and ankle surgeries, and it has achieved satisfactory treatment outcomes. However, whether its effect on the physicians with different seniority levels is different remains unknown. OBJECTIVE： To analyze the difference of 3D printing technology effects on physicians engaged in foot and ankle surgeries with different seniority levels.METHODS： Patients with a fracture of the foot and ankle admitted in the Affiliated Hospital of Binzhou Medical University from January 2015 to February 2017 were randomly assigned to different groups according to treatment using traditional technique or 3D printing technology by junior physicians and senior physicians, respectively： junior traditional group, junior 3D group, senior traditional group, and senior 3D group. The operation time, intraoperative blood loss, intraoperative fluoroscopy times, postoperative complications, postoperative American Orthopaedic Foot and Ankle Society（AOFAS） scores were recorded and compared. RESULTS AND CONCLUSION：（1） Eighty-nine eligible patients were included in the study, 29 patients were lost to follow-up for various reasons, and the remaining 60 patients completed the follow-up. All patients fracture healed at 3 months postoperatively.（2） The junior 3D group was significantly superior to the junior traditional group in the operation time, intraoperative bleed loss and intraoperative fluoroscopy time in the treatment of calcaneal fractures and three ankle fractures（P 0.05）.（3） There was no significant difference between senior traditional and senior 3D groups in the operation time, intraoperative bleed loss and intraoperative fluoroscopy time in the treatment of calcaneal fractures, metatarsal fracture and three ankle fractures.（4） Three cases of incision infection were found, including one case of superficial tissue infection in the junior 3D and senior traditional groups, and one case of deep infection in the junior

关 键 词：跟骨 踝关节 骨折 组织工程 3D打印 足踝外科 三维重建 模拟手术 辅助手术 跟骨骨折 踝关节骨折 跖骨骨折 

分 类 号：R318[医药卫生—生物医学工程]