期刊文献+

采用Mimics软件分析骨水泥注入治疗跟痛症的疗效

Efficacy of bone cement injection in the treatment of calcanodynia
原文传递
导出
摘要 目的 采用Mimics软件对跟骨内骨水泥的填充率进行分析,探讨骨水泥填充率对跟痛症疗效的影响.方法 选择2019年9月至2022年12月在福建医科大学附属泉州市第一医院和温州医科大学附属乐清医院骨科门诊就诊的18例跟痛症患者,所有病例均经过半年以上保守治疗,症状无缓解.在局麻下行跟痛部位穿刺,注入骨水泥.手术后将患者跟骨CT扫描数据导入Mimics21.0软件,分离并重建跟骨注入的骨水泥,并计算骨水泥填充率(IR),根据IR的中位数完成低填充率组(IR%<3.15%)、高填充率组(IR%≥3.15%)差异化分组.收集两组患者在术前与术后3个月的视觉模拟评分(VAS)、AOFAS踝-后足评分以及并发症的情况.采用独立样本t检验方法对各组间的差异进行分析.再对IR、术后VAS、术后AOFAS、跟骨体积、骨水泥弥散体积进行Pearson相关性检验,分析跟骨骨水泥的不同填充率对跟痛症疗效的影响.结果 术后低填充率组VAS评分(3.33±1.00)高于高填充率组(2.00±1.00);术后低填充率组AOFAS评分(85.33±3.16)低于高填充率组(92.44±3.13),差异均有统计学意义(t=2.83、4.80,P<0.05);低填充率组术前VAS评分(6.67±1.00)高于术后VAS评分(3.33±1.00),高填充率组术前VAS评分(6.89±0.93)高于术后VAS评分(2.00±1.00);低填充率组术前AOFAS评分(62.67±2.74)低于术后AOFAS评分(85.33±3.16),高填充率组术前AOFAS评分(61.33±3.16)低于术后AOFAS评分(92.44±3.13),差异均有统计学意义(t=10.00、11.56、21.78、19.52,P<0.01),结果显示,高填充率组患者疗效优于低填充率组.术后VAS评分(2.89±1.00)、跟骨体积(65.97±5.12)与IR(2.86±1.08)呈负相关,差异有统计学意义(r=-0.524、-0.475,P<0.05);术后AOFAS评分(87.93±3.15)、骨水泥弥散体积(2.03±0.39)与IR(2.86±1.08)呈正相关,差异有统计学意义(r=0.820、0.970,P<0.05).所有患者手术顺利,术后无穿刺通道感染、神经血管损伤、骨水泥移位等并发症,1例高填充率的患者发生沿穿刺通道骨水泥渗漏.结论 跟骨内骨水泥高填充率组治疗效果较低填充率组明显,但过高的骨水泥填充率可能会增加骨水泥渗漏的风险. Objective To analyze the filling rate of cement in calcaneus and investigate the effect of calcanodynia.Methods A total of 18 patients with calcanodynia in the Orthopedic Outpatient Clinic of Quanzhou First Hospital Affiliated to Fujian Medical University and Yueqing Hospital Affiliated to Wenzhou Medical University were selected from September 2019 to December 2022.All cases were treated conserva-tively for more than half a year without remission of symptoms.The local area was punctured and cement was injected.After the procedure,the calcaneus CT scan data were imported into Mimics 21.0 software,the cement injected into the calcaneus was separated and reconstructed,and the cement filling rate(IR)was calculated,and low filling group(1R%<3.15%)and high filling group(IR%≥3.15%)were set up according to the median of IR.The visual analog score(VAS),AOFAS ankle-hind foot score and com-plications before surgery and 3 months after surgery were collected.Differences between the groups were analyzed using the independent sample t-test method.Then the Pearson correlation test was performed for IR,postoperative VAS,postoperative AOFAS,calcaneus volume,and cement diffusion volume.The effect of different filling rates of calcaneal cement on the efficacy of calcanodynia was analyzed.Results The VAS score was higher in the postoperative low filling group(3.33±1.00)than that in the high filling group(2.00±1.00);The AOFAS score in the postoperative low filling group(85.33±3.16)was lower than that in the high filling group(92.44±3.13).The differences were all statistically significant(t=2.83,4.80,P<0.05);The preoperative VAS score(6.67±1.00)was higher than the postoperative VAS score(3.33±1.00),the preoperative VAS score in the high filling group(6.89±0.93)was higher than the postoperative VAS score(2.00±1.00);The low preoperative AOFAS score(62.67±2.74)was lower than the postoperative AOFAS score(85.33±3.16);The preoperative AOFAS score in the high filling group(61.33±3.16)was lower than the postoperative AOFAS score(92.44±3.13).The differences were all statistically significant(t=10.00,11.56,21.78,19.52,P<0.01).The high filling group had better efficacy than the low filling group.Postoperative VAS score(2.89±1.00)and calcaneus volume(65.97±5.12)were negatively correlated with IR(2.86±1.08)(r=-0.524,-0.475,P<0.05).The postoperative AOFAS score(87.93±3.15)and bone cement diffusion volume(2.03±0.39)were positively correlated with IR(2.86±1.08)(r=0.820,0.970,P<0.05).All patients completed the op-eration successfully after the surgery,and there were no related complications such as puncture channel in-fection,neurovascular injury,and cement displacement,and only one patient with high filling rate had ce-ment leakage along the puncture channel.Conclusion The efficacy in the high cement filling rate group is better than in the low filling rate group,but the high cement filling rate may increase the risk of cement leakage.
作者 吴珊鹏 金亚平 郑立程 李科伦 吴纪奎 郑旭浩 季滢瑶 Wu Shanpeng;Jin Yapin;Zheng Licheng;Li Kelun;Wu Jikui;Zheng Xuhao;Ji Yingyao(Department of Orthopedics,Yueqing Hospital Affiliated to Wenzhou Medical University,Yueqing 325600,China)
出处 《中华实验外科杂志》 CAS 2024年第9期2120-2124,共5页 Chinese Journal of Experimental Surgery
关键词 跟痛症 骨水泥 治疗效果 Calcaneary pain Bone cement Treatment effect 214.010121026
  • 相关文献

参考文献4

二级参考文献22

共引文献228

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部