摘要
目的探讨3D打印辅助精准手术结合加速康复在复杂髋臼骨折中的应用。方法回顾性分析2013年3月~2017年12月我院收治的42例髋臼骨折患者的资料,根据术前是否使用3D打印辅助术前设计分为两组,A组术前采用3D打印辅助术前设计,B组采用普通CT三维重建经验性手术,术后均采用我院中西医结合加速康复方案进行康复。对比分析两组患者的手术时间、出血量、术后24 h VAS疼痛评分、术后Matta骨折复位评分、末次随访Majeed功能评分、并发症的发生情况。结果所有患者均获得随访,随访时间为6~40个月,平均17.5个月;A组手术时间短于B组,术中出血量、输血量均明显少于B组,差异有统计学差异(P<0.05);A组术后24 h的VAS评分低于B组,差异有统计学差异(P<0.05);两组患者的术后Matta骨折复位评分、末次随访Majeed功能评分优良率比较,差异无统计学差异(P>0.05);A组患者均未发生症状性深静脉血栓、感染等严重并发症,B组有3例患者术中出血多,出现失血性休克,经输血抗休克等处理后稳定。结论 3D打印辅助精准手术结合加速康复治疗复杂髋臼骨折具有更精准、更安全的特点,能减少手术时间,降低出血及输血,降低术后创伤反应,值得临床推广。
Objective To explore the effect of the application of 3D printing assisted precise operation combined with enhanced recovery after surgery in complex acetabular fi＇actures. Methods The data of 42 cases of acetabular fi＇acture treated in our hospital fi＇om March 2013 to December 2017 were analyzed. The patients were divided into two groups according whether they used the 3D printing technology in preoperative design. Croup A used 3D printing to assist preoperative design, while group B underwent routine CT three-dimensional reconstruction. ERAS with combination of traditional Chinese and Western medicine was used for postoperative rehabilitation. The operation time, intraoperative bleeding, 24 hours VAS pain score after operation, postoperative Matta fi＇acture reduction score, Majeed function score of last follow-up, and the complications were compared and analyzed. Results All patients were followed up for 6 to 40 months, an average of 17.5 months. The time of operation in the group A was shorter than that in group B, intraoperative bleed- ing and the amount of blood transfusion in group A were significantly less than those in group B （P〈0.05）.The VAS score of 24 hours in group A after operation was lower than that in group B （P〈0.05）. There was no significant difference be- tween the two groups in the good rates of postoperative Matta fi＇acture reduction score and the final follow-up of the Majeed function score （P〉0.05）. There were no severe complications such as deep venous thrombosis and infection in the group A. In group B, 3 cases of hemorrhagic shock appeared because of bleeding in the operation, stability after trans- fusions and shock treatment. Conclusion 3D printing assisted precision operation combined with enhanced recovery af- ter surgery for complex acetabular fi＇actures has a more accurate and safer feature. It can reduce operation time, reduce bleeding and blood transfusion, and reduce postoperative trauma response. It is worthy of clinical promotion.
作者
徐洲发
肖智青
朱锦忠
王爱明
王凤龙
XU Zhou-fa;XIAO Zhi-qing;ZHU Jin-zhong;WANG Ai-ruing;WANG Feng-long(Department of Orthopedics,Traditional Chinese Medicine Hospital of Heyuan City in Guangdong Province,Heyuan 517000,China)
出处
《中国当代医药》
2018年第28期94-96,99,共4页
China Modern Medicine
基金
广东省中医药局科研项目(20161249)
广东省河源市科技计划项目
关键词
3D打印
髋臼骨折
加速康复
精准治疗
3D printing
Acetabular fracture
Enhanced recovery afler surgery
Precise treatment
