3D打印技术辅助前侧微创入路手术治疗不稳定型骨盆骨折的临床疗效分析

Clinical Analysis of 3D Printing Technique Assisted Anterior Minimally Invasive Approach in the Treatment of Unstable Pelvic Fracture

目的:探讨3D打印技术辅助前侧微创入路手术治疗不稳定型骨盆骨折的临床疗效及安全性。方法:选择2014年8月到2017年2月在我院诊治的骨盆骨折患者78例作为研究对象,按照随机信封抽签原则分为观察组与对照组,每组各39例。对照组采用常规X线与CT进行手术设计,观察组采用3D打印技术进行手术设计,两组都给予前侧微创入路手术治疗,比较两组的手术时间、切口长度、骨折愈合时间、术中出血量、术中和术后并发症的发生情况及术后3个月的骨盆功能优良率。结果:所有患者都完成手术,无术中严重并发症发生,两组手术时间及切口长度对比差异无统计学意义(P>0.05)。对照组的骨折愈合时间、术中出血量显著高于观察组(P<0.05)。观察组术后并发症的发生率(5.1%)显著低于对照组(25.6%)(P<0.05),术后3个月的骨盆功能优良率(97.4%)显著高于对照组(74.4%)(P<0.05)。结论:与常规X线与CT前侧微创入路手术治疗比较,3D打印技术辅助前侧微创入路手术治疗不稳定型骨盆骨折可为患者提供安全、有效、个性化的治疗,减少术后并发症的发生,改善患者的骨盆功能。

Objective： To investigate the clinical efficacy and security of 3D printing technique assisted anterior minimally invasive approach for unstable pelvic fractures. Methods： From August 2014 to February 2017, 78 cases of pelvic fracturespatients pelvic fractures were selected as the research object. All the patients were divided into the observation group and the control group with 39 cases in each group according to the order of admission and the principle of random draw envelope. The control group was given conventional X-ray and CT operation design, the observation group was given the 3D printing technologyoperation design, both groups were given anterior minimally invasive approach surgical treatment. The operation time, incision length, fracture healing time, intraoperative blood loss, intraoperative and postoperative complications and pelvic function rate at 3 months after operation were compared between the two groups. Results： All patients completed surgery and there was no serious complications occurred in both groups, the incision length, operation time showed no significant difference between the two groups（P〉0.05）, the intraoperative blood loss and fracture healing time of observation group were significantly less or shorter than the those of the control group（P〈0.05）. The incidence of complications such as nail tunnel infection, sacral nerve injury, deep vein thrombosis and wound infection in the observation group at 3 months after operation was 5.1%, which was 25.6% in the control group and was significantly higher than that of the observation group（P〈0.05）. The excellent and good rates in the observation group and the control group at 3 months after operation were 97.4% and 74.4%, respectively, which was significantly higher in the observation group than that in the control group（P〈0.05）. Conclusions： Compared with the conventional X-ray and CT operation design, the 3D printing technique assisted anterior minimally invasive approach in the treatment of unstable pelvic fracture can provide a safe, effective and personalized for patients, it reduce the incidence of postoperative complications and improve the pelvic function of patients.