3D打印模拟手术方法在肱骨近端Neer四部分骨折中的优势及对术后功能恢复的影响  

Advantages of 3D printing simulation surgery method in the proximal humeral Neer four-part fractures and its influence on postoperative functional recovery

作　　者：戴峰 王青[2] 王江 范志豪 蒋正宇 DAI Feng;WANG Qing;WANG Jiang;FAN Zhihao;JIANG Zhengyu(Department of Orthopedics,Liyang Branch,Jiangsu Provincial People’s Hospital,Jiangsu Province,Liyang 213300,China;Department of Joint Surgery,Jiangsu Provincial People’s Hospital,Jiangsu Province,Liyang 210029,China)

机构地区：[1]江苏省人民医院溧阳分院骨科,江苏溧阳213300 [2]江苏省人民医院关节外科,江苏南京210029

出　　处：《中国医药导报》2020年第36期95-98,104,共5页China Medical Herald

基　　金：高层次卫生人才“六个一工程”拔尖人才项目(LGY2019037)。

摘　　要：目的探讨3D打印模拟手术方法在肱骨近端Neer四部分骨折中的优势、术后功能恢复的效果。方法选取2017年1月—2020年1月江苏省人民医院溧阳分院收治的肱骨近端Neer四部分骨折患者60例,采用随机数字表法将其分为3D组和传统组,每组各30例。两组均采用锁定钢板结合微创钢板接骨术治疗,3D组采用三维重建建立3D打印模型,模拟实施手术工程后,按照计划对患者实施手术。比较两组手术时间、手术出血量、术中C臂下透视次数、解剖复位率、骨折愈合时间、术后不同时间患者肩关节功能(Constant-Murley评分)及手术并发症。结果3D组手术时间、手术出血量、术中C臂下透视次数、骨折愈合时间均低于传统组,差异均有统计学意义(均P<0.05)。3D组解剖复位率高于传统组,差异有统计学意义(P<0.05)。术后6个月,两组疼痛、肌力、日常活动、关节活动范围及Constant-Murley总分均较术后3个月升高,差异均有统计学意义(均P<0.05)。术后3个月,3D组疼痛、肌力、日常活动、关节活动范围及Constant-Murley总分均高于传统组,差异均有统计学意义(均P<0.05);术后6个月,3D组疼痛、肌力、日常活动、关节活动范围及Constant-Murley总分与传统组比较,差异均无统计学意义(均P>0.05)。3D组手术并发症发生率低于传统组,差异有统计学意义(P<0.05)。结论3D打印模拟手术方法在肱骨近端Neer四部分骨折中应用对于缩短手术时间、减少手术出血、提高复位效果、改善术后肩关节早期功能恢复等方面具有一定的优势。Objective To explore the advantages of 3D printing simulation surgery method in the proximal humeral Neer four-part fractures and the effect of postoperative function recovery.Methods A total of 60 patients with proximal humeral Neer four-part fractures who were admitted to Liyang Branch,Jiangsu Provincial People’s Hospital from January 2017 to January 2020 were selected and divided into 3D group and traditional group by random number table method,with 30 patients in each group.Both groups were treated with locking plate combined with minimally invasive plate osteosynthesis,and the 3D group was treated with three-dimensional reconstruction to establish 3D printing model.After simulating the implementation of surgical engineering,the patients were operated according to the plan.Operative time,amount of surgical bleeding,number of intraoperative C-arm fluoroscopy,anatomic reduction rate,fracture healing time,shoulder joint function of patients at postoperative difference time(Constant-Murley score)and surgical complications were compared between the two groups.Results Operative time,amount of surgical bleeding,number of intraoperative C-arm fluoroscopy and fracture healing time in the 3D group were all lower than those in the traditional group,with statistically significant differences(all P<0.05).The anatomic reduction rate of the 3D group was higher than that of the traditional group,and the difference was statistically significant(P<0.05).Six months after the surgery,pain,muscle strength,daily activity,range of joint activity and Constant-Murley total score were all increased in the two groups compared with the three months after the surgery,and the differences were statistically significant(all P<0.05).Three months after the surgery,pain,muscle strength,daily activity,range of joint activity and Constant-Murley total score in the 3D group were all higher than those in the traditional group,with statistically significant differences(all P<0.05).Six months after the surgery,pain,muscle strength,daily activity,r

关 键 词：3D打印模拟手术 肱骨近端 Neer四部分骨折 肩关节功 

分 类 号：R687.3[医药卫生—骨科学]