三维数字规划和二维胶片模板测量辅助全髋关节置换的效果比较  

Comparison of 3-dimensional computerized preoperative planning and conventional 2-dimensional templating for THA

作　　者：徐征宇 杜俊炜 姜瑶 刘江毕 郑刚 耿硕[1] Xu Zhengyu;Du Junwei;Jiang Yao;Liu Jiang;Bi Zhenggang;Geng Shuo(Department of Orthopedics,The First Affiliated Hospital of Harbin Medical University Harbin Heilongjiang,150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150000

出　　处：《生物骨科材料与临床研究》2021年第2期17-22,共6页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的比较运用三维数字规划技术进行三维规划和传统二维胶片模板测量进行初次全髋关节置换术前规划的效果。方法2018年12月至2019年10月在哈尔滨医科大学附属第一医院行初次单侧全髋关节置换(THA)的102例患者根据其采用的术前规划的类型分为未规划组(37例)、二维规划组(27例)、三维规划组(38例),分别对各组手术时间、术中出血量、住院时间等数据,以及术后髋关节功能评分、影像学资料进行统计学分析,比较不同术前规划的效果。结果未规划组、二维规划组、三维规划组手术时间分别为(87.86±13.13) min、(81.63±7.82) min、(70.21±7.92) min;术中出血量分别为(351.41±55.48) mL、(313.04±53.86) mL、(272.37±70.04) mL;住院时间分别为(9.73±1.94) d、(8.59±2.21) d、(8.00±1.49) d。三维规划组在手术时间、术中出血量和住院时间上与其余两组比较,差异有统计学意义(P<0.05)。术后6个月未规划组、二维规划组、三维规划组髋关节Harris评分分别为(79.62±3.98)分、(84.70±3.77)分、(89.00±5.45)分,三维规划组和其余两组比较,差异均有统计学意义(P<0.05)。术后影像学评估:未规划组、二维规划组和三维规划组的髋臼假体匹配满意率分别为54.0%、63.0%、86.8%;下肢不等长发生率分别为24.3%、14.8%、5.3%;股骨偏距异常发生率分别为48.6%、40.7%、15.8%,三维规划组和其余两组比较,差异均有统计学意义(P<0.05)。结论运用三维数字规划进行全髋关节置换三维术前规划能够辅助术者更加快速、精准地进行全髋关节置换术,同时能让患者获得更快的康复和更好的术后功能。Objective To Compare the effect of 3-dimensional computerized preoperative planning and traditional 2-dimensional templating for primary total hip arthroplasty.Methods From December 2018 to October 2019,102 patients with primary unilateral total hip arthroplasty(THA)in the First Affiliated Hospital of Harbin Medical University were divided into three groups according to the type of preoperative planning:Non planning group(37 cases),traditional2 D templating group(27 cases),3 D computerized preoperative planning group(38 cases).The operation time,intraoperative blood loss,postoperative hip function score and X-ray imaging of each group were statistically analyzed to compare the effect of different THA planning.Results The operation time of non planning group,2 D planning group and 3 D planning group were(87.86±13.13)min,(81.63±7.82)min,(70.21±7.92)min;intraoperative blood loss were(351.41±55.48)mL,(313.04±53.86)mL,(272.37±70.04)mL;the hospitalization time was(9.73±1.94)d,(8.59±2.21)d,(8.00±1.49)d,respectively.There were significant differences in operation time,intraoperative blood loss and hospitalization days between the 3 D planning group and the other two groups(P<0.05).Six months after operation,Harris scores of hip in were(79.62±3.98),(84.70±3.77)and(89.00±5.45),respectively.There were significant differences between the 3 D planning group and the other two groups(P<0.05).According to postoperative imaging evaluation,the satisfaction rate of acetabular prosthesis matching of non planning group,2 D planning group and 3 D planning group were 54.0%,63.0%,86.8%;the lower limb discrepancy rate were 24.3%,14.8%,5.3%,respectively;and the incidence of abnormal femoral offset were 48.6%,40.7%and 15.8%,respectively,there were significant differences between the 3 D planning group and the other two groups(P<0.05).Conclusion 3 D computerized preoperative planning could assist the surgeon to operate THA more quickly and accurately,at the same time,patients get better postoperative function and faster rehabili

关 键 词：全髋关节置换术 模板测量 三维规划 

分 类 号：R687.42[医药卫生—骨科学]