3D打印辅助腹直肌旁切口精准微创治疗骨盆骨折临床效果观察

Clinical Effect of 3D Printing-assisted Pararectus Abdominis Incision for Precise and Minimally Invasive Surgery of Pelvic Fractures

目的观察3D打印辅助腹直肌旁切口精准微创治疗骨盆骨折的临床效果。方法选取骨盆骨折40例,按照入院先后顺序将其分成研究组(21例)和对照组(19例)两组,研究组行3D打印辅助腹直肌旁切口精准微创治疗,对照组行腹直肌旁切口手术。观察比较两组临床相关指标、术前和术后24 h应激程度指标、术后1周并发症发生情况及随访3个月时骨盆功能恢复情况。结果研究组手术时间、住院时间及切口长度短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.01)。术后24 h,两组血清皮质醇、血管紧张素Ⅱ和去甲肾上腺素水平均高于术前,研究组血清皮质醇、血管紧张素Ⅱ和去甲肾上腺素水平均低于对照组,差异有统计学意义(P<0.05或P<0.01)。术后1周,研究组并发症发生率9.52%低于对照组并发症发生率36.84%,差异有统计学意义(P<0.05)。随访3个月时,研究组优良率85.71%高于对照组优良率78.95%,但差异无统计学意义(P>0.05)。结论3D打印辅助腹直肌旁切口精准微创治疗骨盆骨折手术时间和住院时间短,术中出血量少,应激程度轻,术后并发症少,且骨盆功能恢复良好。

Objective To observe the clinical effect of 3D printing-assisted pararectus abdominis incision for precise and minimally invasive surgery of pelvic fractures.Methods Forty patients with pelvic fractures were selected and divided into research group(n=21)and control group(n=19)according to the order of admission.The control group underwent pararectus abdominis incision surgery and 21 patients in the research group underwent 3D printing-assisted pararectus abdominis incision for precise and minimally invasive surgery.The clinical indicators,stress level indicators before and at 24 h after surgery,the incidence of postoperative complications at 1 week after surgery and pelvic function recovery at 2-month follow-up were observed and compared.Results The duration of operation,length of hospitalization and incision length of the research group were shorter than those of the control group,and the amount of intraoperative blood loss was less than that of the control group(P<0.01).The levels of serum cortisol,angiotensinⅡand norepinephrine in the two groups at 24 h after operation were higher than those before operation,and the levels of the above indicators were lower in the research group than in the control group(P<0.05 or P<0.01).At 1 week after surgery,the incidence of postoperative complications in the research group was 9.52%,which was lower than that(36.84%)in the control group(P<0.05).The excellent and good rate of the research group was 85.71%,which was higher than 78.95%of the control group(P>0.05).Conclusion 3D printing assisted pararectus abdominis incision for precise and minimally invasive surgery of pelvic fractures has several advantages,including shorter duration of operation and hospital stay,less intraoperative blood loss,less stress,fewer postoperative complications,and better pelvic function recovery.