3D打印辅助手术治疗胫骨平台骨折疗效的Meta分析

A meta-analysis of the efficacy of three-dimensional printing-assisted surgery for tibial plateau fractures

背景:3D打印这一技术在骨科领域的应用前景广阔,特别是在胫骨平台骨折这类复杂手术中,具有很好的指导和辅助作用,目前国内外相关研究较少,缺乏循证医学证据,不能很好地说明问题。目的:通过M eta分析对比3D打印技术辅助手术与传统的非3D打印技术辅助手术修复胫骨平台骨折的疗效差异。方法:计算机检索M EDLINE、Cochrane图书馆、Embase、中国生物医学文献数据库、CNKI、万方数据库,手动检索相关文献的参考文献等,收集3D打印技术辅助手术与传统的非3D打印技术辅助手术修复胫骨平台骨折的对比研究,严格评价纳入研究的质量并提取数据,统计学软件采用采用S tata 11.0(Stata Corporation,College Station,TX)软件。结果与结论:(1)共纳入7篇对照研究,受试者共362例;(2)Meta分析显示,与传统的非3D打印技术辅助手术修复胫骨平台骨折相比,3D打印辅助技术组的手术时间短(SMD=-2.411,95%CI为-2.718至-2.104,P=0.00)、术中出血量少(SMD=-1.579,95%CI为-1.842至-1.316,P=0.00);其他指标如术后膝关节Rasmussen评分优良率和术后膝关节H SS评分优良率,2组差异无显著性意义(P>0.05),(3)以上结果表明,在治疗胫骨平台骨折时,与传统的手术方法相比,3D打印辅助技术辅助手术能明显缩短手术时间、减少术中出血量。

BACKGROUND： Three-dimensional （3D） printing technology exhibits a broad future in the orthopedics, especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures. However, the related researches are few, and there is a lack of evidence-based medicine to confirm its application values. OBJECTIVE： To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of fibial plateau fractures through a meta-analysis. METHODS： MEDLINE, Cochrane library, Embase, CBM, CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually, to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures. Methodology quality of the trials was assessed cdtically and relative data were extracted, followed by analysis on Stata 11.0 （Stata Corporation, College Station, TX） software. RESULTS AND CONCLUSION： （1） Seven controlled trials involving 362 patients were included. （2） Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time （SMD=-2.411, 95%CI=-2.718--2.104, P=0.00） and less intraoperative blood loss （SMD=-1.579, 95%CI=-1.842--1.316, P=0.00） than those in the traditional surgery. The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps （P 〉 0.05）. （3） To conclude, compared with the traditional surgery, the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.