人工全膝关节置换术中3D打印技术的临床应用及前景展望

发布时间：2018-06-22 10:36

  本文选题：3D打印技术 + 膝骨关节炎　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察、分析、研究对严重膝骨关节炎患者应用3D打印截骨导板技术辅助进行人工全膝关节置换术的临床应用效果与价值及对3D打印技术辅助人工全膝关节置换术的应用前景进行简单评价。术后使用艾叶散熏洗配合功能练习,探究艾叶散是否有助于患者的功能康复。方法:于2013年11月至2015年12月在我院初次行单侧人工全膝关节置换术的膝骨关节炎患者中随机抽取60例进行观察、分析、研究。其中,男21例,女39例;年龄在55-80岁,平均(68.83±7.16)岁。于应用3D打印截骨导板辅助人工全膝关节置换术的患者中随机抽取30例,再从常规行人工全膝关节置换术的患者中随机抽取30例,构成两组进行对照研究。一组为应用3D打印截骨导板进行人工全膝关节置换术,另一组为对照组,采用常规手术操作进行人工全膝关节置换术。分别记录两组的手术时间、术中及术后的总出血量(总出血量为术中出血量与术后为引流量的总和)、术后膝关节功能改善情况,进行分析、比较,并且评估两组的手术并发症发生概率。两组术后均在医生指导下按康复计划配合艾叶散熏洗进行功能康复练习。从60例在沈阳市骨科医院由同一术者及团队进行初次单侧人工全膝关节置换术的样本中随机抽取10例行艾叶散熏洗配合功能练习的患者进组,为实验组,抽取10例未行艾叶散熏洗配合功能练习的患者进组,为对照组,进行随机对照实验,评估配合艾叶散熏洗进行功能康复练习的效果。此次研究采用美国膝关节协会评分(American the knee society knee score,KSS)KSS评分方法对全膝关节置换术后膝关节及功能进行评分。采用SPSS统计学软件进行统计学的分析和处理,通过t检验、x2检验统计学分析来统计相关数据,以P0.05表示差异有统计学意义。结果:两组术后的膝关节KSS评分比两组术前的膝关节KSS评分及功能评分均有所提高,均为P0.05,其差异有统计学意义。对两组之间术后膝关节KSS评分及功能评分的得分进行比较,并无明显区别,P0.05,其差异无统计学意义。两组均未出现手术并发症。3D组的手术耗费时间小于常规组的手术耗费时间,运用统计学t检验方式得出,P0.05,其差异有统计学意义。3D组手术的总出血量少于常规组,通过统计学t检验方式得出,P0.05,其差异有统计学意义。术后使用艾叶散熏洗配合功能练习,经患者自诉,痛楚感减轻,肌肉紧张感减轻,可使患者更加主动进行功能练习,但其无差异无统计学意义,P0.05。结论:人工全膝关节置换术可有效改善严重膝骨关节炎患者的膝关节功能,免除难以忍受的疼痛,提高患者生活质量。3D打印截骨导板辅助进行人工全膝关节置换术与常规人工全膝关节置换术术后患者膝关节功能恢复情况并无明显区别,两者都是安全有效的严重膝骨关节的治疗方式。但应用3D打印截骨导板辅助进行人工全膝关节置换术比常规人工全膝关节置换术的手术时间耗时更少,出血总量更少,并且操作更加简洁,相应的使手术并发症发生概率更小。经患者自诉艾叶散可以减轻患者疼痛感、僵硬感,使患者可以更加主动功能练习。
[Abstract]:Objective: To observe, analyze and study the clinical effect and value of the application of 3D print osteotomy guide for total knee arthroplasty in patients with severe knee osteoarthritis, and to evaluate the application prospect of 3D printing assisted total knee arthroplasty. Methods: from November 2013 to December 2015, 60 cases of knee osteoarthritis were randomly selected from the first unilateral total knee arthroplasty in our hospital for observation, analysis and study. Among them, 21 males and 39 females, aged 55-80 years, average (68.83 + 7.16) years of age, were used in 3D printing osteotomy guide. 30 cases were randomly selected from the patients with plate assisted total knee replacement, and 30 cases were randomly selected from the conventional total knee arthroplasty, and two groups were studied. One group was used 3D print osteotomy guide for total knee replacement, and the other group was a control group. The operation time of the two groups was recorded, the total bleeding amount during and after the operation (the total amount of bleeding was the total amount of bleeding and the flow rate after the operation). After the operation, the improvement of the knee joint function was analyzed and compared, and the incidence of complications in the two groups was evaluated. The two groups were under the guidance of the rehabilitation plan under the guidance of the doctor. 60 cases were randomly selected from the sample of the same operator and team for the first unilateral total knee arthroplasty in the hospital of Shenyang Department of orthopedics. 10 cases were randomly selected from the sample of the first unilateral total knee replacement in the hospital of Shenyang Department of orthopedics. In the control group, a randomized controlled trial was conducted to evaluate the effect of functional rehabilitation exercises with the folium Artemisia. The American the Knee Society knee score, KSS KSS score was used to score the knee joint and function after total knee arthroplasty. Statistical analysis and treatment, by t test, x2 test statistical analysis to statistical data, P0.05 showed statistical significance. Results: the two groups of postoperative knee joint KSS score was higher than the two groups before the operation of the knee joint KSS score and functional scores were all P0.05, the difference was statistically significant. Between the two groups after the operation between the two groups There was no significant difference between the score of KSS and function score of the knee joint, and there was no significant difference between the two groups. The difference between the two groups was less than that of the conventional group, and the difference was statistically significant in the group.3D. The difference was statistically significant in the group.3D. The difference was statistically significant in the group.3D. The amount is less than that of the routine group, and the difference has statistical significance by the t test of statistics. The difference has statistical significance. After the operation, the use of leaf free smoking and washing with function exercises, the patient complained, the pain relief, the muscle tension lightened, can make the patient more active in functional exercise, but there is no difference in statistical significance, P0.05. conclusion: artificial total knee joint placement. It is effective to improve the knee joint function of patients with severe knee osteoarthritis, to relieve the unbearable pain, and to improve the quality of life of the patients with.3D print osteotomy guide for the rehabilitation of knee joint function after total knee replacement and conventional total knee replacement. Both are safe and effective. The treatment of severe knee osteoarthroplasty. But the use of 3D print osteotomy to assist in artificial total knee arthroplasty is less time consuming, less bleeding, more concise operation, and less probability of operation complications. The pain and stiffness make the patient more active.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4;TP391.73
，

本文编号：2052560