3D打印辅助经皮置钉治疗不稳定性骨盆骨折临床效果  

Clinical effect of 3D printing-assisted percutaneous screw fixation in the treatment of unstable pelvic fracture

作　　者：井晟 孟祥圣[1] 尚修超 孙晓[1] 谢永鹏[1] 朱海泉[1] JING Sheng;MENG Xiangsheng;SHANG Xiuchao;SUN Xiao;XIE Yongpeng;ZHU Haiquan(Department of Emergency Surgery,Lianyungang Municipal First People′s Hospital,Lianyungang,Jiangsu Province 222002,China)

机构地区：[1]连云港市第一人民医院急诊外科,江苏连云港222002

出　　处：《介入放射学杂志》2024年第12期1345-1348,共4页Journal of Interventional Radiology

基　　金：江苏省卫生健康委科研项目(H2019109)。

摘　　要：目的评价3D打印辅助经皮置钉治疗不稳定性骨盆骨折的临床效果。方法选取2022年1月至2023年1月在连云港市第一人民医院治疗的80例不稳定性骨盆骨折患者。根据手术方法不同分为经皮置钉组(n=47,3D打印辅助经皮置钉)和切开复位组(n=33,切开复位钢板内固定)。比较两组术中出血量、手术时间、住院时间、骨折愈合时间,血清肌酸激酶(CK)、肌红蛋白(Myo)、乳酸脱氢酶(LDH)水平以及手术并发症发生率。结果经皮置钉组患者手术时间[(62.96±19.31)min比(100.07±26.71)min]、术中出血量[(112.71±25.43)mL比(230.65±30.29)mL]、住院时间[(11.04±2.35)d比(15.16±2.58)d]和骨折愈合时间[(102.18±9.74)d比(113.42±11.52)d]显著低于切开复位组(均P<0.01)。术后3个月经皮置钉组总有效率显著高于切开复位组(95.74%比80.00%)(P<0.05),骨折复位质量优良率高于切开复位组(P<0.05)。术后1、3、6个月经皮置钉组Majeed评分显著高于切开复位组(均P<0.05)。两组术前CK、Myo、LHD水平比较差异无统计学意义(均P>0.05),术后经皮置钉组CK、Myo、LDH水平显著低于切开复位组(均P<0.05)。两组手术并发症发生率比较差异无统计学意义(P>0.05)。结论与切开复位比较,3D打印辅助经皮置钉治疗不稳定性骨盆骨折效果更好,可减少手术创伤,缩短术后恢复时间。Objective To evaluate the clinical effect of 3D printing-assisted percutaneous screw fixation in treating unstable pelvic fracture.Methods A total of 80 patients with unstable pelvic fractures,who received treatment at the Lianyungang Municipal First People′s Hospital of China from January 2022 to January 2023,were enrolled in this study.According to the surgical methods,the patients were divided into percutaneous screw fixation group(n=47,receiving 3D printing-assisted percutaneous screw fixation)and open reduction group(n=33,receiving open reduction with steel plate internal fixation).The intraoperative blood loss,time spent for surgery,total hospitalization time,fracture healing time,levels of serum creatine kinase(CK),myoglobin(Myo),lactate dehydrogenase(LDH)levels,and incidence of surgical complications were compared between the two groups.Results In the percutaneous screw fixation group,the time spent for surgery[(62.96±19.31)min vs(100.07±26.71)min],intraoperative blood loss[(112.71±25.43)mL vs(230.65±30.29)mL],total hospitalization time[(11.04±2.35)days vs(15.16±2.58)days]and fracture healing time[(102.18±9.74)days vs(113.42±11.52)days]were remarkably higher than those in the open reduction group(all P<0.01);the postoperative 3-month total effective rate was 95.74%,which was significantly higher than 80.00%in the open reduction group(P<0.05);and the excellent rate of fracture reduction quality was higher than that in the open reduction group(P<0.05).The postoperative one-,3-and 6-month Majeed scores in the percutaneous screw fixation group were strikingly higher than those in the open reduction group(all P<0.05).No statistically significant differences in the preoperative levels of CK,Myo and LHD existed between the two groups(all P>0.05),while the postoperative levels of CK,Myo and LHD in the percutaneous screw fixation group were prominently lower than those in the open reduction group(all P<0.05).The difference in the incidence of postoperative complications between the two groups was not sta

关 键 词：3D打印 不稳定性骨盆骨折 经皮置钉固定 钢板内固定 

分 类 号：R659[医药卫生—外科学]