机器人辅助与传统置钉在儿童双下肢不等长临时骺阻滞手术中的应用效果比较  

Robot-assisted versus free-hand screw placement in temporary epiphysiodesis surgery in children’s limb length discrepancy

作　　者：董轶非 李强 鲁明 杨征 Dong Yifei;Li Qiang;Lu Ming;Yang Zheng(Department of Pediatric Orthopedics,Beijing Jishuitan Hospital Affiliated to Capital Medical University,National Center for Orthopedics,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院/国家骨科医学中心小儿骨科,北京100035

出　　处：《中国医刊》2024年第6期606-610,共5页Chinese Journal of Medicine

摘　　要：目的比较机器人辅助置钉与传统方式置钉在儿童双下肢不等长8字钢板临时骺阻滞手术中的应用效果。方法回顾性分析2018年1月至2022年12月在首都医科大学附属北京积水潭医院小儿骨科通过8字钢板阻滞股骨及胫骨治疗双下肢不等长的41例患儿的临床资料,根据置钉方式的不同分为观察组(采用骨科机器人辅助置钉,18例)和对照组(采用普通C形臂透视下置钉,23例),比较两组的手术时长、出血量、穿入导针次数、透视次数等指标。结果41例患儿术中均获得精准置钉。观察组手术时长为(68.9±8.3)min,明显短于对照组的(74.8±6.7)min,差异有统计学意义(P=0.015)。观察组出血量为(28.9±9.4)ml,与对照组的(29.6±8.6)ml比较差异无统计学意义(P=0.805)。观察组穿入导针次数为(11.8±1.7)次,术中透视次数为(15.7±1.9)次,均明显少于对照组[分别为(15.2±1.6)次、(20.5±3.6)次],差异有统计学意义(P<0.001)。结论与传统的普通C形臂透视下置钉方式相比,在儿童双下肢不等长8字钢板临时骺阻滞手术中应用机器人辅助置钉具有手术时间短、置钉精度高、透视次数少的优势,值得临床应用。Objective To compare the application effect of robot-assisted nail placement and traditional freehand nail placement in temporary epiphysis block surgery with 8-plate with limb length discrepancy in children.Method From January 2018 to December 2022,41 patients were treated with 8-plate to block the femur and tibia to treat the limb length discrepancy.The robot-assisted operation group used TiRobot system to assist nail placement,and the traditional nail placement group used ordinary C-arm fluoroscopy to assist inserting guide pins.The operation time,blood loss,times of guide pins insertion and fluoroscopy were compared between the two groups,the advantages and disadvantages of the two groups were evaluated.Result All of 41 patients were given accurate nail placement during the operation.The operation time of robot-assisted nail placement group was(68.9±8.3)min,which was better than that of free-hand nail placement group(74.8±6.7)min(P=0.015).The amount of blood loss in robot-assisted nail placement group was(28.9±9.4)ml,and there was no significant difference between the robot-assisted nail placement group and manual nail placement group(29.6±8.6)ml(P=0.805).The number of times that robot-assisted nail placement penetrated into the guide pin was 11.8±1.7,which was significantly better than that of the free-hand nail placement group(15.2±1.6,P<0.001).The times of fluoroscopy in robot-assisted nail placement group were 15.7±1.9,which was significantly better than that in free-hand nail placement group(20.5±3.6,P<0.001).Conclusion Compared with free-hand nail placement,robot-assisted nail placement has the advantages of shorter operation time,higher nail placement accuracy and less fluoroscopy times in the treatment of limb length discrepancy of children's with 8-plate technology,and it is recommended to be popularized in clinic.

关 键 词：双下肢不等长 临时性骨骺阻滞 手术机器人 儿童 

分 类 号：R681.1[医药卫生—骨科学]