3D打印技术辅助手术治疗复杂Pilon骨折的疗效研究  

Study on curative effect of assisted surgical treatment based on 3D printing technology on complex Pilon fractures

作　　者：黄伟 钱锦锋 蔡执中 姜叶飞 Huang Wei;Qian Jinfeng;Cai Zhizhong;Jiang Yefei(Department of Orthopaedics SectionⅣ,the General Hospital of Armed Police Navy,Jiaxing,Zhejiang 314000,China)

机构地区：[1]武警海警总队医院骨四科,浙江省嘉兴314000

出　　处：《中国基层医药》2020年第21期2622-2626,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省嘉兴市科技局公益性研究计划项目(2018AD32183)。

摘　　要：目的探讨基于3D打印技术辅助手术治疗复杂Pilon骨折的疗效。方法选取2017年6月至2018年6月武警海警总队医院骨外科住院治疗的复杂Pilon骨折患者52例为研究对象。根据手术方式分为研究组(n=26)和对照组(n=26)。对照组采用传统切开复位内固定术,研究组在对照组基础上辅以3D打印技术。比较两组患者治疗效果、手术时长、术中出血量、骨折愈合时间、住院时间、并发症发生率,踝关节功能评分、视觉模拟评分法(VAS)评分的差异。结果研究组总有效率为88.5%(23/26),较对照组的65.4%(17/23)高(χ2=3.900,P=0.048)。研究组的手术时长(t=-3.770,P<0.001)、骨折愈合时间(t=-2.206,P=0.032)和住院时间(t=-9.542,P<0.001)均较对照组短,术中出血量(t=-20.226,P<0.001)较对照组少,差异均有统计学意义。研究组并发症总发生率为15.4%(4/23),较对照组的42.3%(11/23)低(χ2=4.591,P=0.032)。随着时间的延长,两组患者的踝关节功能评分逐渐升高,VAS疼痛评分逐渐下降(P<0.05)。术后1个月,研究组踝关节功能评分(t=2.340,P=0.023)较对照组高,但两组患者VAS评分差异无统计学意义(t=-0.278,P=0.782)。末次随访时,研究组踝关节功能评分(t=2.760,P=0.008)较对照组高,VAS评分(t=-3.633,P<0.001)均较对照组低,差异均有统计学意义。结论基于3D打印技术辅助手术治疗复杂Pilon骨折效果优于传统切开复位内固定术,手术时长、骨折愈合时间和住院时间更短,术中出血量更少,并发症发生率更低,术后恢复效果更好。ObjectiveTo explore the curative effect of assisted surgery based on 3D printing technology on complex Pilon fractures.MethodsFrom June 2017 to June 2018,52 patients with complex Pilon fracture treated in the General Hospital of Armed Police Navy were selected in the study.The patients were divided into study group(n=26)and control group(n=26)according to different operation mode.The control group was treated with traditional open reduction and internal fixation,and the study group was supplemented with 3D printing technology.The differences of treatment effect,operation time,intraoperative hemorrhage,fracture healing time,hospitalization time,incidence of complications,ankle function score and VAS pain score between the two groups were compared.ResultsThe total effective rate of the study group was 88.5%(23/26),which was higher than 65.4%(17/23)of the control group(χ2=3.900,P=0.048).The mean operation time(t=-3.770,P<0.001),mean fracture healing time(t=-2.206,P=0.032)and mean hospitalization time(t=-9.542,P<0.001)of the study group were shorter than those of the control group,and the amount of intraoperative bleeding(t=-20.226,P<0.001)was less than that of the control group,the differences were statistically significant.The total incidence of complications in the study group was 15.4%(4/23),which was lower than 42.3%(11/23)in the control group(χ2=4.591,P=0.032).With the development of time,the ankle function score of the two groups increased gradually,and the VAS pain score decreased gradually(P<0.05).One month after operation,the ankle function score of the study group was higher than that of the control group(t=2.340,P=0.023),but there was no statistically significant difference between the two groups in VAS pain score(t=-0.278,P=0.782).At the last follow-up,the ankle function score of the study group was higher than that of the control group(t=2.760,P=0.008),and the VAS pain score of the study group was lower than that of the control group(t=-3.633,P<0.001),the differences were statistically significant.Con

关 键 词：胫骨骨折 骨折固定术 内 成像 三维 计算机辅助设计 3D打印 治疗结果 手术后并发症 

分 类 号：R687.3[医药卫生—骨科学]