多层螺旋CT三维重建辅助3D打印技术对复杂髋臼骨折手术的分析  

Guidance Roles of Multi-slice Spiral CT Three-Dimensional Reconstruction A ssisting 3D Printing Technique in Complex Acetabulum Fracture Surgery

作　　者：苗鹏[1] MIAO Peng(Department of Orthopedics,Tieling Central Hospital,Tieling 112000,Liaoning Province,China)

机构地区：[1]铁岭市中心医院骨科,辽宁铁岭112000

出　　处：《中国CT和MRI杂志》2021年第12期163-166,共4页Chinese Journal of CT and MRI

摘　　要：目的分析多层螺旋CT(MSCT)三维重建辅助3D打印技术对复杂髋臼骨折(AF)手术的指导作用。方法回顾性分析2017年4月至2019年3月我院骨科83例复杂AF患者的临床资料,其中以MSCT三维重建辅助3D打印技术行术前计划的38例为指导组,以传统方法行术前计划的45例为常规组。记录各手术指标,评估骨盆和髋臼复位质量及骨盆、髋关节功能恢复情况,并统计术后不良事件。结果与常规组相比,指导组术中出血量明显少,手术时间、术中透视时间、骨折愈合时间明显缩短(P<0.05)。两组骨盆复位优良率均超过80%,髋臼实现解剖复位、满意复位者占比均超过85%,但组间骨盆及髋臼复位质量未见显著差异(P>0.05)。与术前相比,两组术后3个月、6个月Majeed骨盆量化评分、Harris髋关节评分均显著升高(P<0.05),指导组术后3个月两项评分高于常规组(P<0.05),而术后6个月未见明显差异(P>0.05)。指导组、常规组患者均获得随访,期间指导组不良事件发生率略低于常规组,但差异不具统计学意义(P>0.05)。结论采用MSCT三维重建辅助3D打印技术进行术前指导,可使复杂AF手术更具个性化,继而缩短手术时间和透视时间、减少术中出血量,加快骨折愈合及骨盆、髋关节功能恢复。Objective to analyze guiding roles of multi-slice spiral Ct(MSCt)three-dimensional reconstruction assisting 3D printing technique in complex acetabulum fracture(AF)surgery.Methods the clinical data of 83 patients with complex AF in orthopedics department of the hospital from April 2017 to March 2019 were retrospectively analyzed.Among them,38 cases who underwent preoperative planning with MSCt three-dimensional reconstruction assisting 3D printing technique were enrolled as steering group,while 45 cases who underwent preoperative planning with traditional method were enrolled as routine group.the surgical indexes of the two groups were recorded.the reduction quality of pelvis and acetabulum,and function recovery of pelvis and hip joint were evaluated.the quality of pelvic and acetabular reduction and the functional recovery of pelvic and hip joints were evaluated.the adverse events after operation were counted.results Compared with routine group,intraoperative blood loss was significantly less in steering group,operation time,intraoperative fluoroscopy time and fracture healing time were significantly shorter(P<0.05).the good rates of pelvic reduction in both groups were both higher than 80%.the proportions of acetabulum anatomical reduction and satisfactory reduction were both higher than 85%.However,there was no significant difference in reduction quality of pelvis or acetabulum between the two groups(P>0.05).Compared with those before surgery,scores of Majeed pelvic quantification and Harris hip in both groups were significantly increased at 3 months and 6 months after surgery(P<0.05).At 3 months after surgery,the above two scores in steering group were higher than those in routine group(P<0.05),while there was no significant difference between the two groups at 6 months after surgery(P>0.05).the patients in steering group and routine group were followed up.the incidence of adverse events in steering group was slightly lower than that in routine group(P>0.05).Conclusion the application of MSCt three-dimensiona

关 键 词：多层螺旋CT 三维重建 3D打印技术 复杂髋臼骨折 手术指导 

分 类 号：R445.3[医药卫生—影像医学与核医学] R274.1[医药卫生—诊断学]