摘要
目的分析三维(3D)打印技术结合微创手术治疗骨盆不稳定骨折的临床疗效。方法选取2019年1月-2022年9月江苏省人民医院和江苏省溧阳市人民医院收治的40例不稳定骨盆骨折患者作为研究对象。所有患者在3D打印技术辅助下,通过微创经皮骨盆前环内固定术(Infix)治疗,部分患者后环不稳定,联合钢板内固定治疗。收集手术相关数据,包括手术时间、失血量、重要组织损伤情况、骨折愈合情况以及术后功能的恢复情况;并在随访过程中,对骨折复位情况和肢体功能进行评估。结果40例患者的伤口在第一阶段就已愈合,未发生伤口感染。患者受伤至手术时间平均为(6.0±1.5)d;骨盆骨折固定术的手术时间为30~95 min,平均(60.8±5.9)min;术中平均失血量为(30.6±11.5)mL;骨折愈合时间为(12.8±2.6)周。根据Matta标准评估骨折复位质量:优33例(82.5%),良7例(17.5%);基于Majeed标准的肢体功能评估结果:30例为优秀(75.0%),10例为良好(25.0%)。结论3D打印技术辅助微创手术内固定可以在术前较好地评估患者骨盆骨折情况,有利于建模,可以缩短手术时间,减少术中失血,提高定位精度,最终达到更好的手术效果。
Objective To analyze the clinical efficacy of the combination of three-dimensional(3D)printing technology and minimally invasive surgery in the treatment of unstable pelvic fractures.Methods A total of 40 patients with unstable pelvic fractures treated at Jiangsu Provincial People's Hospital and Liyang People's Hospital from January 2019 to September 2022 were selected as the subjects of the study.All patients were treated with minimally invasive percutaneous anterior pelvic ring internal fixation(Infix)assisted by 3D printing technology,and some patients with posterior ring instability were treated in conjunction with plate internal fixation.Surgical-related data were collected,including time of operation,blood loss,damage to important tissues,fracture healing,and postoperative functional recovery.The scores for fracture reduction and limb function were measured during the follow-up process.Results The wounds of the 40 patients healed at the first stage without wound infection.The average time from injury to surgery was(6.0±1.5)days;the time of operation for pelvic fracture fixation was 30 to 95 minutes,with an average of(60.8±5.9)minutes;the average intraoperative blood loss was(30.6±11.5)mL;the fracture healing time was(12.8±2.6)weeks.According to the Matta criteria for assessing the quality of fracture reduction:33 cases were excellent(82.5%),and 7 cases were good(17.5%).Besides,the limb function assessment results based on the Majeed criteria are as follows:30 cases were excellent(75.0%),and 10 cases were good(25.0%).Conclusion 3D printing technology-assisted minimally invasive surgery internal fixation can better assess the patient's pelvic fracture condition preoperatively,which is beneficial for modeling,can shorten the time of operation,reduce intraoperative blood loss,promote positioning accuracy,and ultimately achieve better surgical outcomes.
作者
刘杰
张文玺
秦晓东
陈建
蒋正宇
Liu Jie;Zhang Wenxi;Qin Xiaodong;Chen Jian;Jiang Zhengyu(Department of Orthopedics,Liyang People's Hospital,Liyang Jiangsu 213300,China;Department of Orthopedics,Jiangsu Provincial People's Hospital,Nanjing 210029,China)
出处
《保健医学研究与实践》
2024年第5期71-77,共7页
Health Medicine Research and Practice
基金
国家自然科学基金资助项目(81902211)。
关键词
数字设计
三维打印
骨盆不稳定骨折
微创内固定手术
Digital design
Three-dimensional printing
Unstable pelvic fractures
Minimally invasive internal fixation surgery
