机器人导航辅助下治疗老年股骨粗隆部骨折临床疗效研究  

Research on clinical efficacy of robot navigation assistance in the treatment of elderly femoral tuberosity fractures

作　　者：马壮 张堃[2] 刘宏亮 李忠[2] 薛汉中[2] 张聪明[2] 赵国龙 杨娜[2] 段丽娜 段宁[2] Ma Zhuang;Zhang Kun;Liu Hongliang;Li Zhong;Xue Hanzhong;Zhang Congming;Zhao Guolong;Yang Na;Duan Lina;Duan Ning(Medical College of Yan′an University,Yan′an 716000,China;Department of Trauma Orthopaedic,Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University,Xi′an 710054,China)

机构地区：[1]延安大学医学院,延安716000 [2]西安交通大学附属红会医院创伤骨科,西安710054

出　　处：《国际外科学杂志》2023年第7期451-456,共6页International Journal of Surgery

基　　金：陕西省科技厅面上项目(S2023-JC-YB-1639)。

摘　　要：目的比较机器人导航辅助与常规方式抗旋转股骨近端髓内钉(PFNA)置入治疗老年股骨粗隆部骨折的临床效果。方法采用回顾性研究的方法分析2022年1月—3月西安交通大学附属红会医院创伤骨科收治的86例老年股骨粗隆部骨折患者的临床数据,其中男性37例,女性49例,年龄63~92岁,平均(79.6±6.9)岁。所有患者均采用股骨近端髓内钉(PFNA)治疗,32例采用机器人导航辅助治疗(机器人组),54例采用传统方法治疗(常规组)。记录两组切口长度、术中透视次数、术中出血量、手术时间。观察两组术后并发症发生情况。比较两组术后3个月髋关节Harris评分优良率。符合正态分布的计量资料以均数±标准差(±s)表示,组间比较采用t检验;计数资料以例和百分比[n(%)]表示,组间比较采用χ~2检验或Fisher确切概率法。结果患者均获随访9~12个月,平均(10.6±0.9)个月。机器人组切口长度、尖顶距为(3.40±0.82)cm、(21.85±1.44)mm,小于常规组的(4.82±0.75)cm、(26.83±1.75)mm(P<0.05);机器人组术中透视次数、导针调整次数分别为(14.53±3.26)、0次,小于常规组(20.67±4.84)、(2.83±1.42)次(P<0.05);机器人组术中出血量、术后1 d引流量为(87.03±9.41)、(46.40±8.91)mL,小于常规组的(110.00±12.52)、(69.62±10.22)mL(P<0.05)。两组患者住院天数、手术时间差异无统计学意义(P>0.05)。机器人组术后并发症发生率为9.4%,小于常规组的42.6%,差异有统计学意义(χ^(2)=11.88,P=0.036)。机器人组术后髋关节功能优良率75.0%,常规组66.7%,差异无统计学意义(χ^(2)=0.66,P=0.416)。结论机器人导航辅助下行PFNA术治疗老年股骨粗隆部骨折可临床疗效较好,可减少手术切口长度和术中透视次数,降低术后并发症发生率,有助于实现手术微创化和老年股骨粗隆部骨折快速康复。Objective To compare the clinical effects robot navigation assisted and conventional proximal femoral nail antirotation(PFNA)implantation and fixation in the treatment of elderly femoral trochanteric fractures.Methods A total of 86 elderly patients with tuberosity fracture of the femur were admitted as research samples from January to March in 2022 in the Department of Trauma Orthopaedic,Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University,including 37 males and 49 females,who aged from 63 to 92 years,with an average age of(79.6±6.9)years.All patients were treated with intramedullary nails(PFNA),32 with dimensity robotic-assisted therapy(robot group)and 54 with traditional methods(conventional group).The length of incision,the number of intraoperative fluoroscopy,the amount of intraoperative blood loss,and the operation time were recorded.The occurrence of postoperative complications in the two groups was observed.The rate of excellent hip Harris score at 3 month after surgery was compared between the two groups.Measurement data with normal distribution were represented as mean±standard deviation(±s),and the comparison between groups was conducted using the t-test;the comparison of count data were represented as[n(%)],and was conducted by Chi-square test or Fisher exact probability between groups.Results All patients were followed up for 9 to 12 months,with an average of(10.6±0.9)months.The incision length and tip apex distance(TAD)of the robot group were(3.40±0.82)cm and(21.85±1.44)mm,which were smaller than(4.82±0.75)cm and(26.83±1.75)mm in the conventional group(P<0.05 for all).The number of intraoperative fluoroscopy and guide needle adjustment[(14.53±3.26)and 0 times]in the robot group were less than those in the conventional group[(20.67±4.84)and(2.83±1.42)](P<0.05).The intraoperative blood loss and drainage rate of the robot group were(87.03±9.41)and(46.40±8.91)mL,which were smaller than that of the conventional group[(110.00±12.52)and(69.62±10.22)mL](P<0.05).There was no signi

关 键 词：老年人 股骨骨折 机器人 骨折固定术 

分 类 号：R687.3[医药卫生—骨科学]