摘要
目的探讨快速康复管理路径在3D打印辅助手术治疗骨盆、髋臼骨折中的应用效果。方法回顾性分析2017年7月至2019年7月期间南方医科大学第三附属医院骨科应用3D打印技术辅助腹直肌外侧入路治疗的98例骨盆、髋臼骨折患者资料。根据是否采用快速康复管理路径分为两组:观察组49例,男29例,女20例;年龄为(38.9±10.2)岁,采用快速康复管理路径实施围手术期管理。对照组49例,男33例,女16例;年龄为(37.9±9.9)岁,采用常规围手术期护理。比较两组患者的术后疼痛视觉模拟评分(VAS)、住院时间、并发症发生率、末次随访时患髋功能及满意度等。结果两组患者术前一般资料的比较差异均无统计学意义(P>0.05),具有可比性。观察组患者的并发症发生率(8.2%,4/49)显著低于对照组患者(46.9%,23/49),差异有统计学意义(P<0.05)。观察组患者术前、术后24 h、术后36 h疼痛VAS评分[(4.1±1.2)、(3.4±1.1)、(1.6±0.9)分]显著低于对照组患者[(6.4±1.1)、(5.2±1.2)、(3.6±1.2)分],住院时间[(15.9±2.2)d]显著长于对照组患者[(23.0±2.9)d],差异均有统计学意义(P<0.05)。末次随访时根据髋关节Harris评分标准评定患髋功能:观察组优30例,良12例,可7例,优良率为85.7%;对照组优29例,良14例,可6例,优良率为87.8%,差异无统计学意义(P>0.05)。观察组患者的满意度(99.7%,635/637)高于对照组患者(84.6%,539/637),差异有统计学意义(P<0.05)。结论快速康复管理路径应用于3D打印辅助手术治疗骨盆、髋臼骨折患者的围手术期管理可取得良好疗效。
Objective To investigate the effectiveness of Enhanced Recovery After Surgery Management Pathway(ERASMP)in the 3D printing-assisted surgery for pelvic and acetabular fractures.Methods A retrospective analysis was conducted of the 98 patients who had been treated at Department of Orthopaedics,The Third Hospital Affiliated to Southern Medical University for pelvic and acetabular fractures by 3D printing-assisted surgery via the lateral-rectus approach from July 2017 to July 2019.They were divided into 2 groups according to application of ERASMP or not.In the observation group of 49 patients(29 males and 20 females with an age of 38.9 years±10.2 years),ERASMP was applied in the perioperative care;in the control group of 49 patients(33 males and 16 females with an age of 37.9 years±9.9 years),perioperative care was conducted in a traditional manner with no use of ERASMP.The 2 groups were compared in terms of postoperative visual analogue scale(VAS),length of hospital stay,incidence of complications,and functional recovery of the affected hip and satisfaction at the last follow up.Results There was no statistically significant difference in the preoperative general data between the 2 groups(P>0.05),indicating comparability.The complication incidence in the observation group(8.2%,4/49)was significantly lower than that in the control group(46.9%,23/49)(P<0.05).The VAS scores at preoperation and 24 h and 36 h after operation(4.1±1.2,3.4±1.1 and 1.6±0.9)were significantly lower in the observation group than in the control group(6.4±1.1,5.2±1.2 and 3.6±1.2)(P<0.05);the length of hospital stay(15.9 d±2.2 d)was significantly longer in the observation group than in the control group(23.0 d±2.9 d)(P<0.05).The hip function assessed at the last follow-up according to the Harris hip scores was excellent in 30 cases,good in 12 cases and good in 7 cases(giving an excellent and good rate of 85.7%)in the observation group while it was excellent in 29 cases,good in 14 cases and fair in 6 cases(giving an excellent and good rate of 87.8%)in the control group,showing no statistically significant difference between the 2 groups(P>0.05).The satisfaction rate of the patients in the observation group(99.7%,635/637)was significantly higher than that in the control group(84.6%,539/637)(P<0.05).Conclusion Compared with traditional perioperative care,Enhanced Recovery After Surgery Management Pathway may lead to good clinical outcomes when it is applied in the 3D printing-assisted surgery for pelvic and acetabular fractures.
作者
肖杏玲
曾先彩
陈小芳
樊仕才
周俊
Xiao Xingling;Zeng Xiancai;Chen Xiaofang;Fan Shicai;Zhou Jun(Department of Orthopaedics,The Third Hospital Affiliated to Southern Medical University,Guangzhou 510630,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2020年第12期1089-1093,共5页
Chinese Journal of Orthopaedic Trauma
基金
广东省医学科学技术研究基金项目(C2018074)。
关键词
骨盆
髋臼
骨折
3D打印技术
快速康复管理路径
Pelvis
Acetabulum
Fractures,bone
3D printing technology
Enhanced Recovery After Surgery Management Pathway
