3D打印模型及模拟手术在DDH全髋关节置换术中的应用效果  

Application Effect of 3D Printing Model and Simulated Surgery in Total Hip Arthroplasty in Hip Developmental Dysplasia Patients

作　　者：汤勇 曾昭池 朱志勇 吴开元 余明阳 袁永端 Tang Yong;Zeng Zhaochi;Zhu Zhiyong;Wu Kaiyuan;Yu Mingyang;Yuan Yongduan(Department of OrthopaedicsI,No.922 Hospital of Joint Logistic Support Force,Hengyang 420002,China)

机构地区：[1]联勤保障部队第九二二医院骨一科,湖南衡阳420002

出　　处：《实用骨科杂志》2023年第8期698-702,共5页Journal of Practical Orthopaedics

基　　金：联勤保障部队第九二二医院中青年科研项目(2022YL05)。

摘　　要：目的观察3D打印模型及模拟手术在发育性髋关节发育不良(developmental dysplasia of the hip,DDH)全髋关节置换术(total hip arthroplasty,THA)中的应用效果。方法以2020年8月至2022年10月联勤保障部队第九二二医院骨一科收治的60例DDH患者作为研究对象,采用随机数字表法进行分组,每组各30例。A组按照常规操作完成THA术,B组采用3D打印技术制作患髋实体模型进行手术方案设计和模拟手术。A组男13例,女17例;年龄36~69岁,平均(54.81±7.03)岁。B组男10例,女20例;年龄35~70岁,平均(52.09±7.44)岁。比较两组手术指标、术后恢复指标、术前及术后假体匹配率、术中股骨劈裂骨折发生率、术后髋臼-股骨联合前倾角、并发症发生率、术前及术后4周髋关节功能[Harris髋关节评分(Harris hip score,HHS)]。结果B组术中出血量较A组少,手术时间、术后下地时间、住院时间较A组短(P<0.05);B组术前、术后假体匹配率(90.00%)较A组(30.00%)高,术中股骨劈裂骨折发生率(0.00%)较A组(50.00%)低(P<0.05);术后4周,两组HHS评分均较术前上升(P<0.05),组间对比差异无统计学意义(P>0.05);两组术后髋臼-股骨联合前倾角比较差异无统计学意义(P>0.05);两组患者术后均未出现股神经及坐骨神经损伤、假体松动及脱位、肺栓塞、下肢深静脉血栓、假体周围骨折、关节感染等并发症。结论3D打印模型及模拟手术应用于DDH患者THA术中效果确切,能提高假体匹配率,降低术中股骨劈裂骨折发生率,缩短手术时间,减少术中出血量,促进康复,值得临床推广应用。Objective To observe the application effect of 3D printing model and simulated surgery in total hip arthroplasty(THA)for developmental dysplasia of the hip(DDH).Methods A total of 60 patients with DDH admitted to Department of Orthopedics I of NO.922 hospital of Joint Logistic Support Force from August 2020 to December 2022 were selected as the research object,and 30 patients were divided into groups by random number table method.In group A,the THA was completed according to routine operation.In group B,3D printing technology was used to make a solid model of the affected hip for surgical scheme design and simulated surgery.In group A,there were 13 males and 17 females.The patients’age ranged from 36 to 69 years,with a mean of(54.81±7.03)years.In group B,there were 10 males and 20 females.The patients age ranged from 35 to 70 years,with a mean of(52.09±7.44)years.The operation indexes,postoperative recovery indexes,matching rate of prosthesis before and after operation,incidence rate of intraoperative femoral condyle fracture,postoperative acetabular-femoral anteversion angle,incidence rate of complications and hip joint function(Harris hip score,HHS)before and 4 weeks after operation were compared between the two groups.Results The intraoperative blood loss in group B was less than that in group A,the operation time,postoperative ground time,and hospital stay in group B were shorter than those in group A(P<0.05).The matching rate of prosthesis before and after operation in group B(90%)was higher than that in group A(30%),and the incidence rate of intraoperative femoral condyle fracture(0%)was lower than that in group A(50%)(P<0.05).At 4 weeks after operation,HHS score in both groups were higher than those before operation(P<0.05),bue there was no significant difference between the two groups(P>0.05).There was no significant difference in postoperative acetabular-femoral anteversion angle between the two groups(P>0.05).No complications such as femoral and sciatic nerve injury,prosthesis loosening and dislocat

关 键 词：3D打印技术 发育性髋关节发育不良 全髋关节置换术 髋关节功能 

分 类 号：R687.42[医药卫生—骨科学]