多层螺旋CT联合3D打印在旋转不稳定性骨盆骨折治疗中的应用  

Application of multi-slice spiral CT combined with 3D printing in the treatment of rotationally unstable pelvic fractures

作　　者：阿力木·克热木 梁志林[1] 帕孜拉·艾拉 麦麦提艾力·阿不力克木 艾克白尔·吐逊[1] Alimu·Keremu;Liang Zhilin;Pazila·Aila;Maimaitiaili·Abulikemu;Aikebaier·Tuxun(Department of Orthopedics and Trauma,The First People’s Hospital of Kashi,Kashi 844000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]喀什地区第一人民医院创伤骨科,新疆维吾尔自治区喀什市844000

出　　处：《中国组织工程研究》2023年第27期4345-4350,共6页Chinese Journal of Tissue Engineering Research

基　　金：“珠江学者·天山英才”合作工作室创新团队计划(KDYY202020),项目负责人:阿力木·克热木;新疆天山创新团队计划(2017D14015),项目负责人:阿力木·克热木。

摘　　要：背景:骨盆骨折是严重骨折类型,单纯多层螺旋CT三维影像显示效果存在二维平面局限性,在骨盆骨折术前方案指导上存在不足。目的:分析多层螺旋CT联合3D打印进行术前指导应用于旋转不稳定性骨盆骨折的临床效果。方法:纳入2017年1月至2020年12月喀什地区第一人民医院收治的90例旋转不稳定性骨盆骨折患者,按随机数字表法分组,研究组(n=47)进行切开复位内固定前采用多层螺旋CT联合3D打印进行术前指导,对照组(n=43)进行切开复位内固定前采用多层螺旋CT进行术前指导。术后随访1年,记录两组骨折愈合时间,评估骨盆复位质量,参考Majeed骨盆量化评分标准评价术后骨盆功能恢复结果,以及术后不良事件发生率。结果与结论:(1)研究组螺钉错位率低于对照组(P <0.05),骨折愈合时间短于对照组(P <0.05),术后3个月的骨盆骨折复位质量优良率高于对照组(P <0.05);(2)与术后3个月比较,两组术后6,12个月的骨盆功能评分升高(P <0.05),两组间术后3,6,12个月的骨盆功能评分比较差异无显著性意义(P> 0.05);(3)研究组47例中,发生骨折移位1例、创伤性关节炎2例,不良事件发生率为6%;对照组43例中,发生畸形愈合1例、异位骨化1例、骨折移位2例、创伤性关节炎2例、骨盆不稳2例,不良事件发生率为19%;两组间不良事件发生率比较差异无显著性意义(P> 0.05);(4)结果表明,对于旋转不稳定性骨盆骨折,相较于单纯采用多层螺旋CT进行术前指导,采用多层螺旋CT联合3D打印进行术前指导可提升骨折复位质量、缩短骨折愈合时间及降低螺钉错位率。BACKGROUND: Pelvic fractures are a serious type of fracture, and there are limitations in the two-dimensional plane display effect of pure multi-slice spiral CT three-dimensional images, and there is a lack of preoperative planning guidance for pelvic fractures.OBJECTIVE: To analyze clinical effect of multi-slice spiral CT combined with 3D printing in patients with rotationally unstable pelvic fractures.METHODS: From January 2017 to December 2020, clinical data of 90 patients with rotationally unstable pelvic fractures admitted to the First People’s Hospital of Kashgar were included. They were grouped according to the random number table method. In the study group, 47 patients underwent multi-slice spiral CT combined with 3D printing technology to guide the operation. In the control group, 43 patients used multi-slice spiral CT for preoperative guidance before open reduction and internal fixation. After 1 year of follow-up, the fracture healing time of the two groups was recorded to evaluate the quality of pelvic reduction. The pelvic function recovery results were evaluated with reference to the Majeed pelvic quantitative scoring standard. The postoperative adverse event rate in the two groups was calculated. RESULTS AND CONCLUSION:(1) The screw dislocation rate in the study group was lower than that in the control group(P < 0.05), and the fracture healing time was shorter than that in the control group(P < 0.05). The excellent and good rate of pelvic fracture reduction 3 months after operation was higher in the study group than that of the control group(P < 0.05).(2) Compared with 3 months after operation, the pelvic function scores of the two groups at 6 and 12 months after operation were higher(P < 0.05). There was no significant difference in pelvic function scores between the two groups at 3, 6, and 12 months after operation(P > 0.05).(3) Among the 47 cases in the study group, 1 case of fracture displacement and 2 cases of traumatic arthritis occurred, and the incidence of adverse events was 6%. Among the

关 键 词：多层螺旋CT 3D打印技术 骨盆骨折 不稳定性骨盆骨折 钢板内固定 复位质量 手术指标 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学] R575.2