3D打印脊柱侧弯矫形器治疗青少年脊柱侧弯的多准则决策模型评价  

Multi-criteria decision model in treatment of adolescent scoliosis with three-dimensional printed scoliosis orthosis

作　　者：张鸿生 黄汉伟 王金武[3] 郑俊伟 刘日新 廖梓杰 王鹏 许苑晶 王赞博 万克明 Zhang Hongsheng;Huang Hanwei;Wang Jinwu;Zheng Junwei;Liu Rixin;Liao Zijie;Wang Peng;Xu Yuanjing;Wang Zanbo;Wan Keming(Department of Orthopedics,Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine,Zhongshan 528415,Guangdong Province,China;Department of Endocrinology,Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine,Zhongshan 528415,Guangdong Province,China;Department of Orthopedics,The Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200000,China;Department of Rehabilitation,Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine,Zhongshan 528415,Guangdong Province,China;School of Biomedical Engineering,Shanghai Jiao Tong University,Shanghai 200000,China;Institute of Translational Medicine,Shanghai Jiao Tong University,Shanghai 201100,China)

机构地区：[1]中山陈星海中西医结合医院骨科,广东省中山市528415 [2]中山陈星海中西医结合医院内分泌科,广东省中山市528415 [3]上海交通大学医学院附属第九人民医院骨科,上海市200000 [4]中山陈星海中西医结合医院康复科,广东省中山市528415 [5]上海交通大学生物医学工程学院,上海市200000 [6]上海交通大学转化医学研究院,上海市201100

出　　处：《中国组织工程研究》2024年第30期4806-4811,共6页Chinese Journal of Tissue Engineering Research

基　　金：中山市科学技术局项目(2022B1055),项目负责人:张鸿生。

摘　　要：背景:传统脊柱侧弯矫形器存在制作工艺流程复杂、加工周期长、贴合性差等缺点,3D打印脊柱侧弯矫形器具有制造精度高、个性化等优势。目的:基于多准则决策模型评价3D打印脊柱侧弯矫形器治疗脊柱侧弯的疗效。方法:回顾性收集2019年1月至2022年10月收治于中山陈星海中西医结合医院的72例脊柱侧弯患者的临床资料,根据治疗矫形器的不同分为2组,研究组23例采用3D打印脊柱侧弯矫形器治疗,传统组49例采用传统的聚丙烯脊模塑柱矫形器治疗。比较两组患者临床疗效以及并发症发生状况;建立3D打印脊柱侧弯矫形器治疗脊柱侧弯的多准则决策模型,并对两组效益值、风险值及决策模型的稳定性进行评价。结果与结论:①研究组患者治疗6个月后,顶椎偏移距离、Cobb角、顶椎旋转度、功能性运动评分、目测类比评分以及总有效率与传统组相比均显著改善,差异有显著性意义(P<0.05);②效益指标中对患者病情影响最大的是Cobb角,风险指标影响较大的是呼吸困难;③研究组和传统组治疗脊柱侧弯效益值分别为79和64,风险值分别为74和57,综合效益和风险值发现研究组治疗方法的效益-风险值比传统组高出16;④在0-100%风险相对权重范围内,研究组的效益-风险总值总是高于传统组,证明多准则决策模型的稳定性较好;⑤提示3D打印脊柱矫形器能够更好地恢复脊柱侧弯青少年的脊柱生理弯曲,提高治疗有效率。BACKGROUND:Traditional scoliosis orthosis has some disadvantages,such as complex manufacturing process,long processing cycle,poor fit and so on.Threedimensional printed scoliosis orthosis has the advantages of high manufacturing precision and personalization.OBJECTIVE:To evaluate the efficacy of three-dimensional printed scoliosis orthosis for scoliosis based on multi-criteria decision model.METHODS:Clinical data of 72 patients with scoliosis admitted to Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to October 2022 were retrospectively collected and divided into two groups according to the treatment of orthosis.Study group(n=23)received three-dimensional printed scoliosis orthosis.Traditional group(n=49)received the traditional polypropylene spine brace treatment.The clinical efficacy and complications were compared between the two groups.A multi-criteria decision model for the treatment of scoliosis with three-dimensional printed scoliosis orthosis was established,and the stability of the benefit value,risk value and decision model of the two groups were evaluated.RESULTS AND CONCLUSION:(1)Compared with the traditional group,there were significant differences in the top vertebral offset distance,Cobb angle,top vertebral rotation,Functional Movement Screen score,visual analog scale score and total effective rate in the study group at 6 months after surgery(P<0.05).(2)Among the benefit indexes,Cobb angle had the greatest impact on the condition of patients,while the risk indexes had the greatest impact on dyspnea.(3)The benefit values of the study group and the traditional group for scoliosis were 79 and 64,and the risk values were 74 and 57,respectively.The combined benefit and risk values found that the benefit-risk value of the study group was 16 higher than that of the traditional group.(4)In the range of 0-100%relative risk weight,the benefit-risk value of the study group was always higher than that of the traditional group,which proved that the multi-criteria

关 键 词：3D打印 脊柱侧弯矫形器 青少年脊柱侧弯 疗效 多准则决策模型 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R682.3