摘要
目的 探讨3D打印技术辅助治疗成人锁骨中段移位骨折的临床应用价值.方法 回顾性收集我院2016年1-12月手术治疗的40例成人锁骨中段移位骨折患者临床资料,依手术方式的不同分为A、B组,每组均为20例.A组术前行健侧锁骨CT扫描获得原始数据,导入mimics17.0软件行三维重建并镜像生成患侧模型,导入3D打印机打印出患侧镜像模型.术前依模型进行术前规化,术中依模型指导进行微创手术.B组采用传统C臂型X线机透视下微创手术.记录两组患者手术时间、术中出血量、透视次数、术后住院时间.术后3 d及末次随访时行肩关节疼痛VAS评分及肩关节功能Neer评分.结果 所有患者术后获得近6个月随防.A、B组患者手术时间分别为（35.8± 11.6）min与（50.1 ±15.5）min（t=3.303,P=0.002）、术中出血量分别为（38.4 ± 9.3）ml与（60.3 ± 10.2）ml（t=7.095,P=0.000）、透视次数分别为（5.2± 1.6）次与（9.7± 2.1）次（t=7.622,P=0.000）、术后住院时间分别为（6.7±0.5）d与（7.0±0.6）d（t=1.717,P=0.093）,差异均有统计学意义.两组患者术后3 d及末次随访时患者肩关节疼痛VAS评分及肩关节功能Neer评分均较术前显著好转（P均〈0.05）,而术后3 d及末次随访时两组间VAS评分及肩关节功能Neer评分比较差异均无统计学意义（P均〉0.05）.结论 3D打印技术辅助微创手术治疗成人锁骨中段移位骨折具有手术时间短、术中出血量少、透视次数少的特点,临床随访效果满意.
Objective To investigate the clinical value of 3D printing technique in the treatment of adult displaced clavicle fracture.Methods The clinical data of forty adult patients with displaced clavicle fracture treated in Yan＇ an University Affiliated Hospital from January 2016 to December 2016 were retrospectively collected.According to different surgical methods,the patients were divided into group A and group B,with 20 cases in each group.The group A received the CT scan of the uninjured lateral clavicle before operation to obtain the original data.The mimics 17.0 software was used to perform 3D reconstruction and to generate the affected side mirror model.The 3D printer was introduced to print the affected mirror model.According to the model of preoperative planning,minimally invasive surgery was performed under model guidance.The group B（20 cases）was underwent minimally invasive surgery via conventional C arm fluoroscopy.The operation time,blood loss,fluoroscopy times and postoperative hospital stay in the two groups were recorded.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up were recorded.Results All patients received postoperative follow-up for nearly 6 months.The operation time of the two groups were（35.8±11.6）min and（50.1＋15.5）min（t=3.303,P=0.002）,the intraoperative blood loss were（38.4±9.3）ml and（60.3±10.2）ml（t=7.095,P=0.000）, respectively,the fluoroscopy times of the two groups were（5.2±1.6）times and（9.7±2.1）times（t=7.622,P=0.000）respectively,the postoperative hospitalization stay were（6.7±0.5）d and（7±0.6）d（t=1.717,P=0.093）,the differences were statistically different.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up in both two groups were improved significantly than those in preoperative（P〈0.05）,while there were no significant differences in the two scores between the two groups（P〉0.05）.Conclusion 3D printing technique assisting minimally invasive surgery for displaced clavicle fractures in adults has the advantages of shorter operation time,less intraoperative blood loss and less fluoroscopy.The clinical follow-up Results are satisfactory.
出处
《中国综合临床》
2017年第10期873-877,共5页
Clinical Medicine of China
基金
陕西省社会发展科技攻关项目（2015SF115）
延安市科技惠民计划项目（2016HM-10-03）
关键词
3D打印技术
镜像模型
锁骨骨折
微创手术
3D printing technology
Mirror image model
Clavicle fracture
Minimally invasive surgery
