基于MSCT三维重建评估老年股骨颈骨折分型的临床应用价值研究  

Clinical Application Value of MSCT ThreeDimensional Reconstruction to Evaluate The Classification of Femoral Neck Fracture in The Elderly

作　　者：余华[1] 李少星[2] 刘战立[1] YU Hua;LI Shao-xing;LIU Zhan-li(Department of Orthopaedics,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan Province,China)

机构地区：[1]成都医学院第一附属医院骨科,四川成都610500 [2]成都医学院第一附属医院妇产科,四川成都610500

出　　处：《中国CT和MRI杂志》2022年第9期163-164,共2页Chinese Journal of CT and MRI

基　　金：四川省教育厅自然科学基金(17ZA0149)。

摘　　要：目的 分析MSCT三维重建评估老年股骨颈骨折分型的临床应用价值。方法 回顾性收集2016年1月至2018年1月在本院收治的149例股骨颈骨折患者的临床资料,根据检查分型方法 不同分为常规组(X线检查后Garden标准进行分型)79例,MSCT组(MSCT三维重建后分型)70倒,对患者所得图像进行分析,对比两组患者内固定手术治疗情况,对所有进行内固定治疗手术的患者进行随访2年,了解其预后不良情况。结果 常规组79例患者,Ⅰ型24例,Ⅱ型30例,Ⅲ型16例,Ⅳ型9例, 30例(37.97%)患者行内固定手术治疗。MSCT组70例患者,MSCT-Ⅰ型17例,MSCT-Ⅱ,型26例,MSCT-Ⅲ型为人工关节置换术27例,其中行内固定治疗术者占比为(37.14%),两组间行内固定治疗者比较无差异(χ^(2)=01.01,P=0.917)。常规组随访2年后出现骨折不愈合、股骨头坏死情况分别为15.18%、20.25%,MSCT组为1.42%、2.85%,两者骨折不愈合、股骨头坏死情况比较,常规组明显高于MSCT组(P<0.05)。结论 MSCT三维重建可全面、准确的显示出股骨颈骨折损伤情况况,为临床正确分型、治疗方案选择提供全面参考资料,对患者预后有好的影响,临床应用价值高。Objective To analyze the clinical application value of MSCT three-dimensional reconstruction to evaluate the classification of femoral neck fracture in the elderly.Method The clinical data of 149 patients with femoral neck fractures admitted in our hospital from January 2016 to January 2018 were retrospectively collected.According to the different classification methods,they were divided into the conventional group(typed according to Garden standard after X-ray examination),79 patients.and the MSCT group(typed after MSCT three-dimensional reconst ruction),70 patients.The images of the patients were analyzed,and the condition of surgert of internal fixation was compared between the two groups.All patients undergoing surgery of internal fixation were followed up for 2 years to understand their poor prognosis.Results In the79 patients in the conventional group,24 were type Ⅰ,30 were type Ⅱ,16 were type Ⅲ 9 were typeⅣ,and 30(37.97%) patients were treated with internal fixation.In70 patients in the MSCT group,17 patients were MSCT-Ⅰ type,26 patients were MSCT-Ⅱ type,and 27 patients were MSCT-Ⅲ type.Among them,the proportion of patients undergoing internal fixation was(37.14%).There was no difference in the proportion of patients with internal fixation between the two groups(χ^(2)=0.011,P=0.917).The incidences of nonunion and femoral head necrosis were 15.18% and 20.25% in the conventional group after follow-up for 2 years,and 1.42% and 2.85% in the MSCT group,respectively.The incidences of the conventional group were significantly higher than those of the MSCT group(P<0.05).Conclusion MSCT three-dimensional reconstruction can comprehensively and accurately display the injury of femoral neck fracture,provide com p rehensive reference for clinical correct classification and the selection of treatment.It has a good impact on the prognosis of patients,and has high clinical application value.

关 键 词：MSCT 三维重建 老年股骨颈骨折 分型 临床应用 

分 类 号：R445.3[医药卫生—影像医学与核医学]