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

Clinical application study of the lateral edge of the rectus abdominis incision combined with three-dimensional digital model for treatment of acetabular fracture following with pelvic fracture

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 of 48 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.Results①The Surgical completion rate were 100%.②The operation time for experrmental group was shorter than that in the control group(P<0.05).③The intraoperative blood loss for experrmental group was more lesser than that in the control group(P<0.05).④The fracture healing time for the experimental group was significantly shorter than that in the control group(P<0.05).⑤For 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.