3D打印联合跗骨窦下小切口空心钉内固定治疗创伤性跟骨骨折的效果  

Effect of 3D Printing Combined with Hollow Nail Internal Fixation with Small Incision under Tarsal Sinus in the Treatment of Traumatic Calcaneal Fracture

作　　者：余曦[1] YU Xi(Department of Emergency Surgery,Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院急诊外科,贵州贵阳550002

出　　处：《中国医学创新》2024年第25期10-14,共5页Medical Innovation of China

摘　　要：目的:探究3D打印联合跗骨窦下小切口空心钉内固定治疗创伤性跟骨骨折的效果。方法:选择2019年1月—2023年1月在贵州省人民医院治疗的创伤性跟骨骨折患者120例,应用随机数字表法将其分为对照组(行跗骨窦下小切口空心钉内固定)及观察组(行3D打印联合跗骨窦下小切口空心钉内固定),各60例。对比两组临床效果、围手术期指标(手术时间、出血量、透视次数)、影像学指标(跟骨Bhler角、Gissane角、跟骨高度、跟骨长度、跟骨宽度)、踝关节功能(踝-后足评分)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、C反应蛋白(CRP)]、应激反应[皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)]。结果:观察组优良率高于对照组,手术时间短于对照组,透视次数、出血量均少于对照组,差异均有统计学意义(P<0.05)。术后,两组Bhler角、Gissane角、跟骨高度、跟骨长度、跟骨宽度与术前比较,差异均有统计学意义(P<0.05);两组术后以上指标比较,差异均无统计学意义(P>0.05)。术后,两组踝-后足评分均升高,观察组高于对照组,TNF-α、IL-1、CRP、Cor、NE、AngⅡ水平均显著升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:3D打印联合跗骨窦下小切口空心钉内固定治疗创伤性跟骨骨折,可减轻手术创伤,减轻炎症反应、应激反应,促进踝关节功能恢复。Objective:To explore the effect of 3D printing combined with hollow nail internal fixation with small incision under tarsal sinus in the treatment of traumatic calcaneal fracture.Method:A total of 120 patients with traumatic calcaneal fracture treated in Guizhou Provincial People's Hospital from January 2019 to January 2023 were selected and divided into the control group(received hollow nail internal fixation with small incision under tarsal sinus)and the observation group(received 3D printing combined with hollow nail internal fixation with small incision under tarsal sinus)by random number table method,with 60 cases in each group.The clinical effect,perioperative indicators(surgery time,bleeding volume,fluoroscopy times),imaging indicators(Bhler angle and Gissane angle of calcaneous,calcaneal height,calcaneal length and calcaneal width),ankle joint function(foot and ankle score),inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),C reactive protein(CRP)],stress response[cortisol(Cor),norepinephrine(NE),angiotensinⅡ(AngⅡ)]were compared between two groups.Result:The excellent and good rate of the observation group was higher than that of the control group,the surgery time was shorter than that of the control group,the fluoroscopy times and bleeding volume were less than those of the control group,the differences were statistically significant(P<0.05).There were significant differences in Bhler angle,Gissane angle,calcaneal height,calcaneal length and calcaneal width between two groups after surgery and before surgery(P<0.05).There were no significant differences in the above indexes between the two groups after surgery(P>0.05).After surgery,the foot and ankle scores in both groups were increased,and that in the observation group was higher than that in the control group,the levels of TNF-α,IL-1,CRP,Cor,NE and AngⅡin both groups were decreased,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion

关 键 词：3D 打印 跗骨窦下小切口空心钉内固定 创伤性跟骨骨折 炎症反应 应激反应 

分 类 号：R687.3[医药卫生—骨科学]