3D打印技术辅助内固定术联合续断接骨汤治疗复杂性胫骨平台骨折患者的临床研究  

Application of 3D Printing Technology Combined with Xuduan Jiegu Decoction in Patients with Complex Tibial Plateau Fracture

作　　者：王倩 毕龙 严亚玲 WANG Qian;BI Long;YAN Ya-ling(Orthopedic Operating Room,First Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710032;Department of Orthopedics,First Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710032)

机构地区：[1]空军军医大学第一附属医院骨科手术室,陕西西安710032 [2]空军军医大学第一附属医院骨科,陕西西安710032

出　　处：《世界中西医结合杂志》2022年第6期1150-1154,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金面上项目(81672189)。

摘　　要：目的观察复杂性胫骨平台骨折患者采取3D打印技术联合续断接骨汤治疗时,患者整体获益情况,旨在指导临床骨折患者的治疗。方法选取2019年3月—2020年11月期间空军军医大学第一附属医院收治的126例复杂性胫骨平台骨折患者,根据患者及家属选取的治疗方案分为对照组(63例,3D打印技术辅助内固定)与治疗组(63例,3D打印技术辅助内固定+续断接骨汤)。两组均治疗60 d。对比不同时点患者证候总积分、骨折愈合情况、膝关节功能(采用Rasmussen膝关节功能评估)、炎症因子[C反应蛋白(C-reactive protein,CRP)、白细胞介素-8(Interleukin-8,IL-8)]、骨代谢[骨保护素(Osteoprotegerin,OPG)、碱性磷酸酶(Alkaline phosphatase,ALP)、尿脱氧吡啶酚(Urine deoxypyridinol,DPD)]及血液流变学(全血黏度低切变值、全血黏度高切变值及血浆黏度)。结果治疗结束时,治疗组骨折愈合情况及膝关节功能恢复优良率均高于对照组,差异有统计学意义(P<0.05);治疗1周、治疗结束时,两组患者证候总积分、IL-8、CRP、OPG、ALP、DPD、全血黏度低切变值、全血黏度高切变值、血浆黏度变化趋势不同,与对照组相比,治疗组证候总积分、IL-8、CRP、全血黏度低切变值、全血黏度高切变值、血浆黏度较低,OPG、ALP、DPD高于对照组,差异有统计学意义(P<0.05)。结论3D打印技术联合续断接骨汤治疗复杂性胫骨平台骨折,利于促进膝关节功能恢复,不仅能够降低炎症因子水平,还可改善血液流变学状态,促进骨代谢,缩短骨愈合进程。Objective To observe the overall effect of 3 D printing technology combined with Xuduan Jiegu Decoction on the treatment of patients with complex tibial plateau fractures,thus guiding the clinical treatment of patients with fractures.Methods A total of 126 patients with complex tibial plateau fractures who were admitted to the First Affiliated Hospital of Air Force Medical University from March 2019 to November 2020 were selected.According to the treatment plan selected by the patients and their families,the patients were divided into a control group(3 D printing technology-assisted internal fixation)and an observation group(3 D printing technology-assisted internal fixation+Xuduan Jiegu Decoction),with 63 cases in each group.Both groups were treated for 60 d.The total syndrome score,fracture healing,knee joint function(assessed by Rasmussen knee joint function),inflammatory factors including C-reactive protein(CRP)and interleukin-8,(IL-8),osteoprotegerin(OPG)in bone metabolism,alkaline phosphatase(ALP),urine deoxypyridinol(DPD),and hemorheology(low-shear value ofwhole blood viscosity,high-shear value of whole blood viscosity,and plasma viscosity)of patients in the two groups were compared.Results At the end of treatment,the fracture healing and excellent rate of knee joint function recovery in the observation group were higher than those in the control group(P<0.05).After treatment for 1 week and after treatment,the IL-8,CRP,OPG,ALP,DPD,low-shear value of whole blood viscosity,high-shear value of whole blood viscosity,and plasma viscosity had different changing trends in the two groups.Compared with the control group,the observation group had lower total syndrome score,IL-8,CRP,low-shear value of whole blood viscosity,high-shear value of whole blood viscosity,and plasma viscosity,and higher OPG,ALP,and DPD(P<0.05).Conclusion In the treatment of complex tibial plateau fractures,application of 3 D printing technology combined with Xuduan Jiegu Decoction is beneficial to promote the recovery of knee joint function,

关 键 词：复杂性胫骨平台骨折 3D打印技术 续断接骨汤 血液流变学 

分 类 号：R683.42[医药卫生—骨科学]