3D打印技术在四肢近关节骨折治疗中的应用研究  

Application of 3D Printing in the Treatment of Proximal Articular Fractures of the Extremities

作　　者：陈科明 白龙 陈林清 于志勇 陈西政 付志杰 CHEN Keming;BAI Long;CHEN Linqing(Bao’an District Fuyong People’s Hospital of Shenzhen City,Shenzhen 518103,China)

机构地区：[1]广东省深圳市宝安区福永人民医院,广东深圳518103

出　　处：《中国医学创新》2018年第3期15-19,共5页Medical Innovation of China

基　　金：深圳市宝安区科研项目(2015172)

摘　　要：目的:探讨3D打印技术辅助手术治疗四肢近关节部位骨折患者的临床效果与价值。方法:选取2015年6月-2016年3月本院接受四肢近关节骨折治疗的患者62例。按照不同手术方式将其分为对照组(常规手术)32例和研究组(3D打印技术辅助手术)30例。比较两组手术时间、术中出血量、术后骨折愈合时间、愈合后的不良情况,比较术后6、12、18个月的关节功能恢复评分。结果:研究组平均手术时间(58.6±16.3)min、术中平均出血量(101.68±23.59)mL、平均骨折愈合时间(9.6±2.1)个月,均少于对照组的(72.3±12.6)min、(135.33±18.67)mL、(13.7±2.6)个月,比较差异均有统计学意义(t=-3.716、-6.248、-6.803,P=0.000、0.000、0.000);两组患者均Ⅰ期愈合,术后无感染并发症状,研究组愈合后无疼痛,对照组愈合后出现轻度间歇性疼痛2例,保养护理3个月后消失,两组愈合后的不良情况比较,差异无统计学意义(P>0.05);术后6、12、18个月,研究组关节功能评分均高于对照组,比较差异均有统计学意义(P<0.05)。结论:利用3D打印技术辅助手术治疗四肢近关节部位骨折患者,可帮助术者做出明确的术前诊断、规划手术方案及设计出个性化的内置物,使手术效果个体化、精准化,从而缩短手术时间、减少术中出血量,同时对术后骨折的愈合及关节功能恢复均具有较好的预后效果,值得临床进一步推广应用。Objective:To explore the clinical effect and value of 3D printing assisted operation in the treatment of proximal articular fractures of the extremities.Method:A total of 62 patients with proximal articular fractures of the extremities were treated in our hospital from June 2015 to March 2016 were selected.According to the different surgical methods,they were divided into 32 cases of control group(routine operation)and 30 cases of study group(3D printing technique assisted operation).The operative time,intraoperative bleeding,postoperative fracture healing time,and bad condition after healing were compared between two groups,the joint functional recovery scores were compared at 6,12 and 18 months after operation.Result:The average operative time was(58.6±16.3)min,average intraoperative bleeding was(101.68±23.59)mL,average fracture healing time was(9.6±2.1)months in study group,and control group were(72.3±12.6)min,(135.33±18.67)mL,(13.7±2.6)months respectively,the differences were statistically significant(t=-3.716,-6.248,-6.803;P=0.000,0.000,0.000).They were all healed in stageⅠ,and no complications after the operation,the study group had no pain after healing,2 cases of mild intermittent pain in control group after healing,and disappeared after nursing care 3 months,the bad condition after healing of two groups were compared,the difference was not statistically significant(P>0.05).The scores of joint function in study group were all higher than those of control group at 6,12 and 18 months after the operation,the differences were statistically significant(P<0.05).Conclusion:3D printing assisted operation treatment of proximal articular fractures of the extremities,can help the surgeons to make definite preoperative diagnosis,operation planning scheme and design personalized surgical implants,the effects of individual and accurate,so as to shorten the operative time,less bleeding,and has a good effect on the prognosis of fracture healing and joint functional recovery after surgery,it is worthy of further a

关 键 词：3D打印 近关节 骨折 

分 类 号：R687.3[医药卫生—骨科学] TP391.73[医药卫生—外科学]