腹直肌外侧切口入路及三维数字化模型在髋臼并骨盆骨折中的临床应用研究
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摘要
目的研究腹直肌外侧切口入路及三维数字化模型用于治疗髋臼并骨盆骨折的治疗效果。方法选取2015年1月~2017年1月在廉江市人民医院治疗的髋臼并骨盆骨折患者48例,根据入院时间顺序交错分为试验组和对照组,每组各24例。试验组在腹直肌外侧切口入路术前行髋臼及骨盆骨折常用内固定器械的数字化三维重建,行术前虚拟手术模拟指导实际手术过程;对照组仅行腹直肌外侧切口入路手术,无三维数字化重建及虚拟手术指导。比较两组的手术持续时间、术中出血量、术后愈合时间及术后6个月髋关节运动功能评级的差异。结果 (1)手术完成率100%;(2)试验组手术持续时间显著短于对照组,差异有统计学意义(P<0.05);(3)试验组术中出血量显著少于对照组,差异有统计学意义(P<0.05);(4)试验组骨折愈合时间显著短于对照组,差异有统计学意义(P<0.05);(5)试验组手术6个月后髋关节运动功能恢复评分结果为优和良的比率显著高于对照组,差异有统计学意义(P<0.05)。结论治疗髋臼合并骨盆骨折,在行腹直肌外侧切口入路手术治疗前,进行三维数字化模型及虚拟手术,有利于缩短手术时间,减少手术出血量,缩短骨折愈合时间,提高术后髋关节运动功能评分,值得临床进一步推广。
Objective To study the treatment effect of the lateral edge of the rectus abdominis incision combined with three-dimensional digital model for the acetabular fracture following with pelvic fracture patients.Methods A total of48 patients with acetabular fracture and pelvic fractures from January 2015 to January 2017 in our hospital were selected into this study.They were divided into the experimental group and the control group according to the chronological order of admission,24 cases in each group.In experimental group,the internal fixation devices for acetabulum and pelvic fracture were reconstruction used the three-dimensional digital technology,and the preoperative virtual surgery simulation were used to guide the actual operation process.In control group,there were no the three-dimensional digital technology and the preoperative virtual surgery simulation.The surgical duration time,intraoperative blood loss,healing time,and hip jointmovement function rating after 6 months were compared.Results(1)The Surgical completion rate were 100%.(2)The operation time for experrmental group was shorter than that in the control group(P<0.05).(3)The intraoperative blood loss for experrmental group was more lesser than that in the control group(P<0.05).(4)The fracture healing time for the experimental group was significantly shorter than that in the control group(P<0.05).(5)For the rate of excellence or good in hip jointmovement function rating after 6 months,the experimental group was significantly higher than the control group,the differences were statistically significant(P<0.05).Conclusion For the patients with acetabular fracture and pelvic fractures,the three-dimensional digital reconstruction technology and the preoperative virtual surgery before treatment is conducive to shorten the operation time,reduce the surgical blood loss,shorten fracture healing time,improve the postoperative hip movement function score,and it is worth to further promote in the clinical practice.
Objective To study the treatment effect of the lateral edge of the rectus abdominis incision combined with three-dimensional digital model for the acetabular fracture following with pelvic fracture patients.Methods A total of48 patients with acetabular fracture and pelvic fractures from January 2015 to January 2017 in our hospital were selected into this study.They were divided into the experimental group and the control group according to the chronological order of admission,24 cases in each group.In experimental group,the internal fixation devices for acetabulum and pelvic fracture were reconstruction used the three-dimensional digital technology,and the preoperative virtual surgery simulation were used to guide the actual operation process.In control group,there were no the three-dimensional digital technology and the preoperative virtual surgery simulation.The surgical duration time,intraoperative blood loss,healing time,and hip jointmovement function rating after 6 months were compared.Results(1)The Surgical completion rate were 100%.(2)The operation time for experrmental group was shorter than that in the control group(P<0.05).(3)The intraoperative blood loss for experrmental group was more lesser than that in the control group(P<0.05).(4)The fracture healing time for the experimental group was significantly shorter than that in the control group(P<0.05).(5)For the rate of excellence or good in hip jointmovement function rating after 6 months,the experimental group was significantly higher than the control group,the differences were statistically significant(P<0.05).Conclusion For the patients with acetabular fracture and pelvic fractures,the three-dimensional digital reconstruction technology and the preoperative virtual surgery before treatment is conducive to shorten the operation time,reduce the surgical blood loss,shorten fracture healing time,improve the postoperative hip movement function score,and it is worth to further promote in the clinical practice.
引文
[1]高金华,胡炜,郭晓山.闭合复位内固定联合外固定架治疗不稳定骨盆骨折[J].中国骨伤,2015,28(8):753-756.
[2]詹祖锋,刘晓霞,胡军,等.计算机仿真技术在桡骨远端骨折掌侧锁定钢板放置定位的作用研究[J].中国数字医学,2015,10(6):51-53.
[3]郝申申,刘志斌,王飞,等.3D打印个体化塑形导板在骨盆髋臼骨折治疗中的初步应用[J].中国综合临床,2018,34(1):99-101.
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[5]陈松亮,林涌生,郭仰丹,等.经腹直肌旁入路在同侧髋臼及骨盆骨折手术治疗中的应用[J].中国骨与关节损伤杂志,2016,1(12):1284-1285.
[6]杨志龙,王晶晶.腹直肌外侧直切口手术入路治疗同侧髋臼并骨盆骨折的疗效分析[J].甘肃科技,2016,32(7):97-99.
[7]陈明新,孙根发.同侧髋臼合并骨盆骨折患者经腹直肌外侧直切口入路手术评估[J].中国医师进修杂志,2016,39(3):271-275.
[8]潘金万,阙松林,李棠华,等.多层螺旋CT三维重建技术诊断创伤性肋骨骨折的临床价值分析[J].中国现代医生,2017,55(25):108-110.
[9]李政,卢启贵,黄东红,等.3D打印技术结合虚拟手术与传统手术在治疗复杂胫骨平台骨折的应用疗效比较[J].中国伤残医学,2017,25(10):35-38.
[10]郑翔,许锦煌,黄建荣.应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究[J].实用骨科杂志,2017,23(10):895-898.
[11]费新华,周峰.CT三维重建技术在颌面部骨折中的临床应用分析[J].医学影像学杂志,2017,27(2):353-355.
[12]潘金万,阙松林,李棠华,等.多层螺旋CT三维重建技术诊断创伤性肋骨骨折的临床价值分析[J].中国现代医生,2017,55(25):108-110.
[13]邵晏清,熊然,张潇,等.良stoppa切口入路与腹直肌外侧入路治疗合并骨盆骨折的髋臼骨折的疗效比较[J].医学综述,2016,22(2):380-382.
[14]郑翔,许锦煌,黄建荣.应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究[J].实用骨科杂志,2017,23(10):895-898.
[15]余光书,许长鹏,林焱斌,等.基于3D打印的虚拟手术设计在复杂胫骨平台骨折内固定中的临床效果观察[J].中国医药科学,2017,7(21):181-183.
[2]詹祖锋,刘晓霞,胡军,等.计算机仿真技术在桡骨远端骨折掌侧锁定钢板放置定位的作用研究[J].中国数字医学,2015,10(6):51-53.
[3]郝申申,刘志斌,王飞,等.3D打印个体化塑形导板在骨盆髋臼骨折治疗中的初步应用[J].中国综合临床,2018,34(1):99-101.
[4]刘一江.盆骨骨折合并髋臼骨折复位固定手术的治疗效果[J].中外医学研究,2017,15(6):132-133.
[5]陈松亮,林涌生,郭仰丹,等.经腹直肌旁入路在同侧髋臼及骨盆骨折手术治疗中的应用[J].中国骨与关节损伤杂志,2016,1(12):1284-1285.
[6]杨志龙,王晶晶.腹直肌外侧直切口手术入路治疗同侧髋臼并骨盆骨折的疗效分析[J].甘肃科技,2016,32(7):97-99.
[7]陈明新,孙根发.同侧髋臼合并骨盆骨折患者经腹直肌外侧直切口入路手术评估[J].中国医师进修杂志,2016,39(3):271-275.
[8]潘金万,阙松林,李棠华,等.多层螺旋CT三维重建技术诊断创伤性肋骨骨折的临床价值分析[J].中国现代医生,2017,55(25):108-110.
[9]李政,卢启贵,黄东红,等.3D打印技术结合虚拟手术与传统手术在治疗复杂胫骨平台骨折的应用疗效比较[J].中国伤残医学,2017,25(10):35-38.
[10]郑翔,许锦煌,黄建荣.应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究[J].实用骨科杂志,2017,23(10):895-898.
[11]费新华,周峰.CT三维重建技术在颌面部骨折中的临床应用分析[J].医学影像学杂志,2017,27(2):353-355.
[12]潘金万,阙松林,李棠华,等.多层螺旋CT三维重建技术诊断创伤性肋骨骨折的临床价值分析[J].中国现代医生,2017,55(25):108-110.
[13]邵晏清,熊然,张潇,等.良stoppa切口入路与腹直肌外侧入路治疗合并骨盆骨折的髋臼骨折的疗效比较[J].医学综述,2016,22(2):380-382.
[14]郑翔,许锦煌,黄建荣.应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究[J].实用骨科杂志,2017,23(10):895-898.
[15]余光书,许长鹏,林焱斌,等.基于3D打印的虚拟手术设计在复杂胫骨平台骨折内固定中的临床效果观察[J].中国医药科学,2017,7(21):181-183.