3D打印联合诱导膜技术用于胫骨骨髓炎伴缺损中的疗效与远期随访结果  

Efficacy and long-term follow-up results of 3D printing combined induction membrane technology in the treatment of tibial osteomyelitis with coloboma

作　　者：麦建林[1] 郭建恩[1] 曾淳[1] 王庆祥[1] MAI Jian-lin(Department of orthopedics,Puji hospital,Dongguan people's hospital,Dongguan,Guangdong,523000,Chinn.)

机构地区：[1]东莞市人民医院普济院区骨科,广东东莞523000

出　　处：《齐齐哈尔医学院学报》2019年第7期816-819,共4页Journal of Qiqihar Medical University

摘　　要：目的 分析3D打印联合诱导膜技术用于胫骨骨髓炎伴缺损中的疗效与远期随访结果。方法 选择2012年8月—2017年8月间本院收治的80例胫骨骨髓炎伴缺损患者作为研究对象,按随机数表法分为对照组与实验组两组,每组各40例。在常规清创的基础上,对照组采用自体骨移植和外固定器固定,实验组采用3D打印联合诱导膜技术。比较两组患者治疗1、3、6个月的VAS评分、Paley骨愈合评分、活动能力及术后并发症发生情况,术后随访12个月,以K-M生存曲线比较两组患者的愈合情况,采用SF-36量表比较患者的生活质量。结果 两组患者术前VAS评分间无明显差异(t=0.202,P=0.840),实验组患者治疗1、3、6个月的VAS评分均低于对照组(t=4.306,8.766,7.262,P=0.000,0.000,0.000),实验组术后6个月的Paley骨愈合优良率高于对照组(67.50%和42.50%,χ~2=5.051,P=0.025),术前实验组和对照组的SF-36量表各项评分间无统计学差异(P>0.05),实验组末次随访的SF-36量表各项评分均高于对照组(P<0.05)。实验组的愈合时间为6(4,8)个月,对照组的愈合时间为8(6,10)个月,实验组的愈合时间明显低于对照组(Log Rankχ~2=6.135,P=0.012)。术前两组患者的6 min最远行走距离与最远行走时间间无显著差异(P>0.05),6个月随访后实验组患者的6 min最远行走距离大于对照组,最远行走时间长于对照组(P<0.05)。实验组术后并发症发生率显著低于对照组(7.50%和25.00%,χ~2=4.501,P=0.034)。结论 3D打印联合诱导膜技术治疗胫骨骨髓炎具有良好的临床疗效、可加快骨愈合和缩短骨缺损填补时间,减少并发症发生率,提高患者生活质量。Objective To analyze the efficacy and long-term follow-up results of 3 D printing combined induction membrane technology in the treatment of tibial osteomyelitis with coloboma. Methods Eighty patients with sacral osteomyelitis and defects admitted to our hospital from June 2012 to June 2017 were randomly divided into the control group and the experimental group,with 40 cases in each group. On the basis of conventional debridement,the control group was fixed with autologous bone graft and external fixator,and 3 D printing combined with induction membrane technology was applied in the experimental group. The VAS score,Paley bone healing score,activity ability and postoperative complications at 1 st,3 rd,and 6 th months were compared between the two groups.The postoperative follow-up period was 12 months. The healing of the two groups was compared by K-M survival curve. The SF-36 scale compares the quality of life of patients. Results There was no significant difference in preoperative VAS scores between the two groups( t = 0. 202,P = 0. 840). The VAS scores of the experimental group were lower than those of the control group at 1 st,3 rd,and 6 th month( t = 4.306,8.766,7.262,P = 0.000,0.000,0.000).The excellent rate of Paley bone healing in the experimental group was higher than that in the control group( 67. 50% and 42. 50%,χ^2= 5. 051,P = 0. 025). There was no significant difference in the preoperative scores of the SF-36 scale between experimental group and the control group( P>0.05).The scores of the SF-36 scale at the last follow-up of the experimental group were higher than those of the control group( P<0.05).The healing time of the experimental group was 6( 4,8) months,and the healing time of the control group was 8( 6,10) months.The healing time of the experimental group was significantly lower than that of the control group( Log Rank χ^2= 6. 135,P = 0. 012). There was no significant difference between the farthest walking distance and the longest walking time of the two groups before operation( P>0.05).A

关 键 词：膜诱导技术 3D打印 胫骨骨髓炎 疗效 远期随访 关节功能 

分 类 号：R681[医药卫生—骨科学]