数字医学与3D打印辅助关节镜治疗肩袖损伤的应用

Application of digital medicine and 3D printing assisted arthroscopy in the treatment of rotator cuff injury

目的探讨数字医学与3D打印技术在关节镜下治疗肩袖损伤的可行性与临床疗效。方法选取2016年4月—2018年4月手术治疗肩袖损伤患者28例为研究对象,采用随机对照研究,按简单随机分为常规关节镜下肩袖修补术治疗14例(A组),应用数字医学与3D打印技术辅助关节镜下肩袖修补术治疗14例(3D组),比较两组患者手术时间、术中出血量、切口长度、住院时间、术后疼痛评分(VAS)和肩关节功能评分(ASES)。结果两组均顺利完成手术并获得6个月以上随访,平均8.1个月。3D组手术时间短,两组比较差异具有统计学意义(P<0.05);术后2周的肩关节VAS评分3D组优于A组,两组比较差异有统计学意义(P<0.001);术后2周的肩关节ASES评分和UCLA评分两组比较无统计学意义(P>0.05);在术后2个月和术后6个月的肩关节VAS评分、ASES评分和UCLA评分两组比较差异无统计学意义(P>0.05)。结论数字医学与3D打印技术辅助关节镜治疗肩袖损伤方案具有个性化、精准化、最优化和手术时间短等优点,同时可缩短年轻医生关节镜学习曲线和提高医患沟通效果。

Objective To explore the feasibility and clinical efficacy of digital medicine and 3D printing technology in the treatment of rotator cuff injury under arthroscopy.Methods Twenty-eight patients with rotator cuff injury treated by surgery from April 2016 to April 2018 were selected as the study subjects.A randomized controlled study was conducted.The patients were randomly divided into the conventional arthroscopic rotator cuff repair group(14 cases in group A)and the digital medicine and 3D printing assisted arthroscopic rotator cuff repair group(14 cases in group 3D)by simple randomization.The operation time,intraoperative blood loss,incision length,hospitalization duration,scores of postoperative pain(VAS)and scores of shoulder joint function(ASES)were compared between the two groups.Results All patients in the two groups successfully went through the operation and were followed up for more than 6 months,with an average of 8.1 months.The operation time of the group 3D was shorter,and the difference in operation time between the two groups was statistically significant(P<0.05).Two weeks after surgery,the VAS score of shoulder joint in the group 3D was better than that of the conventional group,the difference between the two groups was statistically significant(P<0.001).There was no significant difference in the ASES scores and UCLA scores of shoulder joint between the two groups in 2 weeks after operation(P>0.05).There was no significant difference in the VAS scores,ASES scores and UCLA scores between the two groups in 2 months and 6 months after operation(P>0.05).Conclusion Digital medicine and 3D printing assisted arthroscopy in the treatment of rotator cuff injury has the advantages of personalization,precision,optimization and short operation time.At the same time,it can shorten the young doctors’learning curve of arthroscopy and improve the effect of doctor-patient communication.