3D打印导向模板辅助技术在髋部骨折手术中的临床研究  

Clinical study of 3D printed guide template for surgical internal fixation in hip fracture

作　　者：吴帆 王越[2] 曹雷[3] 牛彦辉 张立明 王永平 Wu Fan;Wang Yue;Cao Lei;Niu Yanhui;Zhang Liming;Wang Yongping(Department of the Third Surgery,Hebei Provincial Corps Hospital,Shijiazhuang 050081,China;Department of Anatomy and Histoembryology,Shijiazhuang Medical College,Shijiazhuang 050599,China;Department of Anatomy,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]武警河北省总队医院外三科,石家庄050081 [2]石家庄医学高等专科学校解剖和组胚教研室,石家庄050599 [3]河北医科大学解剖教研室,石家庄050017

出　　处：《创伤外科杂志》2021年第1期15-19,共5页Journal of Traumatic Surgery

基　　金：河北省医学科学研究课题计划项目(20181089)。

摘　　要：目的探讨3D打印导向模板辅助技术在髋部骨折治疗中的应用价值。方法前瞻性随机研究2017年2月—2019年2月武警河北省总队医院及河北医科大学附属医院手术治疗的髋部骨折患者60例,男性34例,女性26例;年龄35~65岁,平均52.5岁。按照随机数字表法分为3D组和常规组,各30例,3D组患者术前首先进行3D数字化重建,虚拟复位及内固定,设计导航模板等;常规组采取常规的手术方法实施治疗。比较两组患者手术时间、手术出血量、术后引流量、术后下床活动时间、复位效果、术后不同时间髋关节功能、手术并发症。结果3D组手术时间(73.9±8.1)min、手术出血量(230.8±30.5)mL均低于常规组(81.0±11.5)min、(285.7±46.2)mL(P<0.05);3D组和常规组术后引流量、术后下床活动时间比较差异无统计学意义(P>0.05);术后复查3D组手术复位效果优80.00%、良20.00%,常规组优56.67%、良40.00%、差3.33%,3D组优于常规组,差异有统计学意义(P<0.05);术后3个月3D组髋关节功能Harris功能评分高于常规组(P<0.05);术后6个月两组患者Harris功能评分比较差异无统计学意义(P>0.05);3D组并发症发生率6.67%(切口感染和肺部感染各1例),常规组并发症率16.67%(切口感染2例、肺部感染2例、内固定松动1例),差异无统计学意义(P>0.05)。结论3D打印导向模板手术内固定在髋部骨折治疗中可减少手术时间和出血量、提高复位效果,促进早期关节功能恢复。Objective To explore the application value of 3D printing guide template assisted technology in the treatment of hip fractures.Methods A prospective randomized research method was used to study 60 patients with hip fractures surgically treated at the Hebei Provincial General Hospital of the Armed Police Force from Feb.2017 to Feb.2019,including 34 male patients and 26 female patients,with an average age of 52.5 years(range,35-65 years).According to random grouping,they are divided into 3D group and conventional group,each with 30 cases.Patients in the 3D group first underwent 3D digital reconstruction before surgery,with operations such as virtual reduction and internal fixation,and navigation templates design.The conventional group adopted conventional surgical methods for treatment.The operation time,surgical blood loss,postoperative drainage,postoperative time of getting out of bed,reduction effect,hip joint function at different postoperative time,and surgical complications were compared between the two groups.Results The operation time(73.9±8.1)minutes and the blood loss(230.8±30.5)mL of the 3D group were less than those of the conventional group(81.0±11.5)minutes and(285.7±46.2)mL(P<0.05).There was no statistically significant difference in postoperative drainage and time of getting out of bed between the 3D group and the conventional group(P>0.05).After postoperative review,the surgical reduction effect of the 3D group was excellent in 80.00%and good in 20.00%,and the routine group was excellent in 56.67%,good in 40.00%,and poor in 3.33%.The surgical reduction effect of the 3D group was better than that of the routine group(P<0.05).Three months after operation,the Harris function score of hip joint function of the 3D group was higher than that of the conventional group(P<0.05);There was no significant difference in Harris function score between the two groups at 6 months after operation(P>0.05).The complication rate of patients in the 3D group was 6.67%(1 case of incision infection and 1 case of lung i

关 键 词：髋部骨折 3D打印 内固定 虚拟复位 

分 类 号：R687.3[医药卫生—骨科学]