成人髋关节发育不良髋部3D重建与测量在全髋置换术中的应用

Application of Hip 3D Reconstruction and Measurement of Adult DDH in Total Hip Arthroplasty

目的探讨成人髋关节发育不良(DDH)髋部3D重建与测量在全髋置换术(THA)中的应用效果。方法将于我院就诊的60例DDH患者随机分为对照组(n=30,采用CT与X线诊断与测量辅助THA治疗)和观察组(n=30,采用基于高分辨CT重建髋部3D模型与测量手术参数辅助THA治疗),比较两组手术指标(手术时间、术中出血量、术后引流量、住院时间);比较术后6个月时两组关节功能状况(Harris髋关节功能评分);比较术前、术后6个月时两组影像测量数据[外展角、前倾角、股骨偏心距(offset)、股骨近端匹配度]、生活质量[简明健康状况调查量表(SF-36)]。结果观察组手术时间明显短于对照组(P<0.05);观察组术中出血量、术后引流量明显低于对照组(P<0.05);两组住院时间无显著差异(P>0.05)。术后6个月时,观察组Harris评分明显高于对照组(P<0.05);两组外展角、前倾角均较术前显著降低,且观察组显著低于对照组(P<0.05);两组offset、股骨近端匹配度、SF-36评分均较术前显著上升,且观察组显著高于对照组(P<0.05)。结论相较于传统CT与X线辅助下术式,将3D重建技术运用于THA更有利于降低患者术中损伤情况,促进患者关节功能的恢复,改善各项影响检查参数,并提高其生活质量。

Objective This paper aims to explore the application effects of hip 3D reconstruction and measurement of adult developmental dysplasia of the hip(DDH) in total hip arthroplasty(THA). Methods 60 patients with DDH treated in our hospital were randomly divided into control group(n = 30,given CT and X-ray diagnosis and measurement to assist THA) and observation group(n = 30,using high-resolution CT-based hip 3D model reconstruction and measurement of surgical parameters to assist THA). The surgical indicators(surgical time,intraoperative blood loss,postoperative drainage volume,hospital stay)were compared between the two groups. The joint function status(Harris hip function score) were compared between the two groups at 6 months after surgery. The imaging measurement data [abduction angle,anteversion angle,femoral offset,proximal femur match]and quality of life[Short-form Health Status Survey Scale(SF-36) ]were compared between the two groups.Results The surgical time in observation group was significantly shorter than that in control group(P<0. 05). The intraoperative blood loss and postoperative drainage volume in observation group were significantly lower than those in control group(P<0. 05).There was no significant difference in hospital stay between the two groups(P>0. 05). At 6 months after surgery,the Harris score in observation group was significantly higher than that in control group(P<0. 05). The abduction angle and anteversion angle in the two groups were significantly lower than those before surgery,and the two indexes in observation group were significantly lower than those in control group(P<0. 05). The offset,proximal femur match and SF-36 scores in the two groups were significantly higher than those before surgery,and the indexes in observation group were significantly higher than those in control group(P<0. 05). Conclusion Compared with traditional CT and X-ray assisted surgical method,3D reconstruction technique for THA is more beneficial to reduce the intraoperative injury,promote the joint function recovery,improve various examination parameters,and enhance the quality of life.