3D成像打印技术在股骨远端骨折手术治疗中应用效果的Meta分析  

Application of 3D imaging and printing technology in surgical treatment of distal femoral fracture cases:a Meta analysis

作　　者：李旻 王娜 张小雨 王宏伟 刘英杰 马春梅 蒋雨宸 LI Min;WANG Na;ZHANG Xiaoyu;WANG Hongwei;LIU Yingjie;MA Chunmei;JIANG Yuchen(Department of Orthopedics,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院骨科,河北省唐山市063000 [2]华北理工大学附属医院耳鼻喉科,河北省唐山市063000 [3]华北理工大学附属医院CT室,河北省唐山市063000

出　　处：《中国煤炭工业医学杂志》2023年第5期479-486,共8页Chinese Journal of Coal Industry Medicine

基　　金：2022年河北省医学适用技术跟踪项目计划(编号:GZ2022060)。

摘　　要：目的对利用3D成像打印技术进行股骨远端骨折手术治疗的临床效果进行Meta分析,评估该方法与常规手术方法相比临床疗效上是否具有优势。方法利用网络以3D打印、3D、mimics、股骨远端骨折、股骨髁骨折、Hoffa骨折为关键词检索中国知网、中国万方数据库、维普网,PubMed、Embase、Cochrane library数据库,检索时间由建库截止到检索日期2023年7月。所得文献经纳入排除标准筛选后再经Cochrane系统评价员手册和Newcastle-Ottawa Scale(NOS)评分评估,提取文献中资料后由RevMan 5.4软件对手术时间、手术出血量、骨折复位满意率、术中X线曝光次数、骨折愈合时间、术后并发症发生率、术后膝关节HSS评分优良率、术后切口引流量、住院时间结果进行统计学分析。结果纳入10篇文献,病例数合计为734例,其中3D成像打印技术辅助组397例,常规组337例。Meta分析结果显示,3D成像打印组在手术时间(SMD=-2.92,95%CI:-3.94~-1.90,P<0.00001)、手术出血量(SMD=-2.35,95%CI:-3.43~-1.27,P<0.0001)、术中X线曝光次数(SMD=-4.48,95%CI:-5.93~-3.04,P<0.00001)、骨折愈合时间(SMD=-1.04,95%CI:-1.67~-0.40,P=0.001)、术后切口引流量(SMD=-1.29,95%CI:-1.52~-1.05,P<0.00001)、住院时间(SMD=-1.97,95%CI:-2.98~-0.96,P=0.0001)均少于常规组;骨折复位满意率(RR=1.14,95%CI:1.05~1.25,P=0.002)、术后膝关节HSS评分优良率(RR=1.09,95%CI:1.01~1.17,P=0.03)优于对照组、术后并发症发生率(RR=0.43,95%CI:0.28~0.64,P<0.0001)少于对照组。结论3D成像打印技术辅助手术治疗股骨远端骨折的临床效果好于对照组,仍需更多高质量外文文献进一步证实该结论。Objective To conduct a Meta analysis of the clinical effects of surgical treatment of distal femur fractures using 3D imaging printing technology,and to assess whether this method has advantages in terms of clinical efficacy compared with conventional surgical methods.Methods CNKI,VIP,and Wanfang databases,PubMed,Embase,The Cochrane library databases were searched using the Internet with the keywords of 3D printing,3D,mimics,distal femur fracture,femoral condylar fracture,and Hoffa fracture,and the search was conducted from the establishment of the library up to the date of the search,July 2023,and the search was completed by the end of the search period.The obtained literature was screened by inclusion and exclusion criteria and then assessed for literature quality by QUADAS,comparing the operation time;operative bleeding;satisfactory rate of fracture reduction;number of intraoperative X-ray exposures;time to fracture healing;incidence of postoperative complications;excellent rate of postoperative knee HSS scores;postoperative incisional drainage;and length of hospitalization.Results Ten papers were included,and the total number of cases was 734,including 397 cases in the 3D imaging printing technology-assisted group and 337 cases in the conventional group.Meta analysis showed that the 3D imaging printing group had the best results in terms of operative time(SMD=-2.92,95%CI:-3.94~-1.90,P<0.00001),operative bleeding(SMD=-2.35,95%CI:-3.43~-1.27,P<0.0001),number of intraoperative X-ray exposures(SMD=-4.48,95%CI:-5.93~-3.04,P<0.00001),time to fracture healing(SMD=-1.04,95%CI:-1.67~-0.40,P=0.001),and amount of postoperative incision drainage(SMD=-1.29,95%CI:-1.52~-1.05,P<0.00001),and hospitalization time(SMD=-1.97,95%CI:-2.98~-0.96,P=0.0001)were less than those of the conventional group;the fracture redundancy satisfaction rate(RR=1.14,95%CI:1.05~1.25,P=0.002),and postoperative knee HSS score excellence rate(RR=1.09,95%CI:1.01~1.17,P=0.03)was better than that of the control group,and the postoperative complication ra

关 键 词：3D打印 3D MIMICS 股骨远端骨折 股骨髁骨折 HOFFA骨折 META分析 

分 类 号：R641[医药卫生—外科学]