摘要
目的评价3D打印技术在成人胸腰椎骨折脱位术前医患沟通与手术规划、操作中的辅助应用效果。方法回顾性收集2016年6月—2017年6月延安大学附属医院脊柱外科收治的49例胸腰椎骨折脱位手术患者的临床资料,依据术前谈话、术前规划及手术操作中是否辅助应用3D打印技术分为3D组23例和常规组26例。3D组术前医患沟通、手术方案设计及手术操作辅助应用3D打印技术,常规组术前医患沟通、手术方案设计及手术操作根据CT、MRI等常规影像资料。观察两组术前医患沟通情况、手术情况、手术疗效。结果 3D组术前谈话时间短于常规组,沟通满意程度优于常规组,差异有统计学意义(P <0. 01); 3D组手术时间短于常规组,术中出血量少于常规组,差异有统计学意义(P <0. 05或P <0. 01);两组术后1周疼痛视觉模拟评分和Oswestry功能障碍指数评分均较术前显著改善(P <0. 01),但两组术后组间比较差异无统计学意义(P> 0. 05)。结论成人胸腰椎骨折脱位手术前沟通及手术规划、操作中辅助应用3D打印技术,有助于提高医患沟通效果、缩短手术时间、减少术中出血量,但在术后康复和关节功能改善方面无明显优势。
Objective To evaluate the effect of auxilial7- application of 3D printing technologies in the pre- operative doctor-patient communication, surgical planning and operation of thoracolumbar fiactures and dislocations in adults. Methods The clinical data of 49 patients with thoracolumbar fiacture and dislocation treated in our hospital fiom June 2016 to June 2017 were retrospectively analyzed. According to preoperative doctor-patient communication, preoperative planning and surgical operation based on 3D printing technologies, the patients were divided into 3D group （ - = 23 ） and conventional group （ - = 26）. In 3 D group, preoperative doctor-patient communication, surgical design and operation were assisted by 3D printing technologies. In conventional group, preoperative doctor-patient communication, surgical design and operation were assisted by conventional imaging data such as CT and MRI. The preoperative doctor-patient communication, operation, and surgical efficacy were observed between the two groups. Results The preoperative conversation time was shorter and commurfication satisfaction were significantly better in 3D group than those in conventional group（P 〈0.01 ）. The ditration of operation and intraoperative blood loss were significant- ly less in 3D group than those in conventional group（P 〈0.05 or P 〈0.01 ）. The postoperative pain score by- visual ana- logue scale and Oswestl7- dysfunction index scores were significantly improved, as compared with those before operation in two groups （P 〈 0.01 ）, but there was no significant difference between two groups after operation （P 〉 0.05 ）. Conclusion The application of 3D printing model in the preoperative communication, surgical design and operation of thoracolmar fiactme and dislocation in adults could improve doctor-patient commmfication efficiency, shorten duration of operation andreduce blood loss. However, it has no obvious advantages in postoperative rehabilitation and improvement of joint flmction.
作者
刘军
郝申申
刘志斌
郭丽萍
刘延雄
李长红
王飞
杜璠
LIU Jun;HAO Shen-shen;LIU Zhi-bin;GUO Li-ping;LIU Yan-xiong;LI Chang-hong;WANG Fei;DU Fan(a.Department of Spinal Surgery,b.Hyperbaric Oxygen Center,1.Affiliated Hospital of Yanhn University,Yanhn,Shaanxi 716000,China;Department of Spinal Surgery,General Hospital of Pingmei Shenma Medial Group,Pingdingshan,Henan 467000,China)
出处
《临床误诊误治》
2018年第10期45-48,共4页
Clinical Misdiagnosis & Mistherapy
基金
陕西省社会发展科技攻关项目(2015SF115)
延安市科技惠民计划项目(2016HM-10-03)
关键词
骨折
脱位
3D打印技术
医患沟通
Fractures
bone
Dislocations
3D printing technology-
Doctor-patient communication
