摘要
目的通过Meta分析比较3D打印技术辅助切开复位内固定(ORIF)与常规手术治疗髋臼骨折的临床疗效差异。方法通过计算机检索建库至2022年7月1日PubMed、EMBASE、Cochrane Library、知网、万方和维普数据库中3D打印技术辅助ORIF与常规手术治疗髋臼骨折的相关文献,根据纳入与排除标准筛选符合的临床对照试验,利用Cochrane评价手册和渥太华纽卡斯尔量表(NOS)对纳入研究进行质量评价,采用RevMan 5.3软件对两组术式临床疗效结果进行统计分析。结果共纳入6篇随机对照试验,14篇非随机对照试验,研究对象821例(3D打印手术组372例,常规手术组449例)。Meta分析结果显示:在手术时间[MD=-43.41,95%CI(-56.19,-30.62),P<0.00001]、术中出血量[MD=-216.47,95%CI(-298.39,-134.56),P<0.00001]、术中透视次数[MD=-5.43,95%CI(-7.71,-3.15),P<0.00001]、术中器械安装时间[MD=-27.31,95%CI(-31.29,-23.33),P<0.00001]、术后CT上残余位移[MD=-0.67,95%CI(-1.12,-0.22),P=0.004]、并发症发生率[OR=0.51,95%CI(0.34,0.76),P=0.001]及创伤性关节炎发生率[OR=0.43,95%CI(0.20,0.94),P=0.03]方面,3D打印手术组优于常规手术组;而在术后骨折复位质量Matta评分优良率、末次随访时髋关节Merle D’Aubigne&Postel评分及Harris评分优良率方面两组相比差异无统计学意义(P=0.07、P=0.11和P=0.69)。结论3D打印技术辅助ORIF治疗髋臼骨折,可缩短手术时间及术中器械安装时间,减少术中出血量、术中透视次数、术后残余位移及术后并发症发生率,是髋臼骨折的一种有效治疗方式。
Objective To compare the clinical effect difference between 3D printing technology assisted open reduction and internal fixation and conventional surgery for acetabular fractures by Meta-analysis.Methods The relevant literatures about 3D printing technology assisted open reduction and internal fixation and conventional surgical treatment of acetabular fractures were searched by computer from PubMed,EMBASE,Cochrane Library,CNKI,Wanfang and VIP databases up to July 1,2022.The clinical controlled trials were selected according to the inclusion and exclusion criteria.The quality of the included studies was evaluated using the Cochrane Risk Bias Assessment Tool and the Newcastle-Ottawa Scale.RevMan 5.3 software was used to statistically analyze the clinical efficacy of the two groups.Results A total of 6 randomized controlled trials and 14 non-randomized controlled trials were included,involving 821 subjects(372 patients in the 3D printing surgery group and 449 patients in the conventional surgery group).Meta-analysis results showed that:In Operative time[MD=-43.41,95%CI(-56.19,-30.62),P<0.00001],intraoperative blood loss[MD=-216.47,95%CI(-298.39,-134.56),P<0.00001],intraoperative fluoroscopy times[MD=-5.43,95%CI(-7.71,-3.15),P<0.00001],intraoperative device installation time[MD=-27.31,95%CI(-31.29,-23.33),P<0.00001],postoperative residual displacement on CT[MD=-0.67,95%CI(-1.12,-0.22),P=0.004],the incidence of complications[OR=0.51,95%CI(0.34,0.76),P=0.001]and the incidence of traumatic arthritis[OR=0.43,95%CI(0.20,0.94),P=0.03],the 3D printing group was better than the conventional group.The excellent and good rate of Matta score in 3D printing surgery group and Merle D'Aubigne&Postel score of hip joint and Harris score were not different from conventional surgery group(P=0.07,P=0.11 and P=0.69).Conclusion 3D printing technology assisted open reduction and internal fixation for acetabular fracture can shorten the operation time and intraoperative instrument installation time,reduce intraoperative bleeding,the number of intraoperative fluoroscopies,postoperative residual displacement and postoperative complication rate,which is an effective treatment for acetabular fractures.
作者
谢宗辉
喻培根
刘瀚文
胡浩
邹龙飞
谭美云
Xie Zonghui;Yu Peigen;Liu Hanwen;Hu Hao;Zou Longfei;Tan Meiyun(Department of Orthopedics,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan,646000,China)
出处
《生物骨科材料与临床研究》
CAS
2023年第3期36-44,共9页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
3D打印
虚拟手术计划
髋臼骨折
切开复位内固定
META分析
3D printing
Virtual surgical planning
Acetabular fracture
Open reduction and internal fxation
Meta-analysis
