骨科机器人辅助下骶髂关节螺钉治疗骨盆后环骨折的疗效研究  

Efficacy of orthopedic robot-assisted sacroiliac joint screws in the treatment of posterior pelvic ring fractures

作　　者：江伟[1] 杨灵[1] 汪红[1] 高博[1] JIANG Wei;YANG Ling;WANG Hong;GAO Bo(Department of Orthopedics,People's Hospital of Deyang City,Deyang,Sichuan 618000,P.R.China)

机构地区：[1]德阳市人民医院骨科,四川德阳618000

出　　处：《华西医学》2022年第4期550-555,共6页West China Medical Journal

摘　　要：目的 探讨骨科机器人辅助下骶髂关节螺钉治疗骨盆后环骨折的临床疗效。方法 纳入2018年1月-2021年8月在德阳市人民医院接受骶髂关节螺钉固定手术的患者,采用随机分组方法将患者分为机器人组和手动组。机器人组采用机器人辅助下置入骶髂关节螺钉,手动组采用手动置入骶髂关节螺钉。比较两组患者的一般情况、骶髂关节螺钉置入时间、术中透视次数、导针钻孔次数、手术出血量、Majeed骨盆功能评分。结果 共纳入42例患者,两组患者的性别、年龄、体质量指数、损伤类型和受伤原因差异无统计学意义(P>0.05)。机器人组19例患者置入21枚螺钉,手动组23例患者置入23枚螺钉。两组患者术后伤口完全愈合,无伤口感染及医源性血管神经损伤,无内固定松动。两组患者的螺钉置入时间、出血量和Majeed评分优良率差异无统计学意义(P>0.05)。机器人组的透视次数[(14.53±4.54)vs.(19.87±5.48)次]和钻孔次数[(1.00±0.00)vs.(7.24±3.77)次]比手动组少,差异有统计学意义(P<0.05)。结论 骨科手术机器人在骶髂关节螺钉置入中具有微创、透视少、置钉确切等优点,在骨盆骨折的治疗中有较好的临床治疗效果。Objective To investigate the clinical effect of orthopedic robot-assisted sacroiliac joint screws in the treatment of posterior pelvic ring fractures. Methods Patients who underwent sacroiliac joint screw fixation in People’s Hospital of Deyang City between January 2018 and August 2021 were included, and the patients were divided into a robotic group and a manual group by randomization. The robot group used robot-assisted insertion of sacroiliac joint screws, and the manual group used manual insertion of sacroiliac joint screws. The general condition, time of sacroiliac joint screw placement, intraoperative fluoroscopy times, guide needle drilling times, surgical blood loss, and Majeed pelvic function score were compared between the two groups. Results A total of 42 patients were included, and there was no significant difference in gender, age, body mass index, injury type or injury cause between the two groups(P>0.05).Finally, 21 screws were placed in 19 patients in the robotic group and 23 screws in 23 patients in the manual group. The wounds of the two groups were completely healed after operation, and there was no wound infection, iatrogenic vascular and nerve injury, and no loosening of internal fixation. There was no significant difference in screw placement time, blood loss or Majeed score between the two groups(P>0.05). The number of fluoroscopy(14.53±4.54 vs. 19.87±5.48) and drilling times(1.00±0.00 vs. 7.24±3.77) in the robotic group were less than those in the manual group, and the differences were statistically significant(P<0.05). Conclusion Orthopedic surgical robots have the advantages of minimally invasive, less fluoroscopy, and accurate screw placement in sacroiliac joint screw placement, and have good clinical results in the treatment of pelvic fractures.

关 键 词：机器人 骨盆 骨折 内固定器 

分 类 号：R687.3[医药卫生—骨科学]