机器人辅助经皮螺钉内固定治疗骨盆和髋臼骨折
发布时间：2018-12-25 15:27
【摘要】：目的:评价一种外科手术机器人辅助经皮螺钉内固定治疗骨盆和髋臼骨折手术的安全性与有效性。方法:选择2016年1至4月北京积水潭医院创伤骨科收治的12例骨盆和髋臼骨折患者为研究对象,将试验对象随机分为试验组和对照组,试验组7例采用机器人辅助下医生完成手术,对照组5例采用透视引导下医生徒手完成手术,通过对两组病例的手术总时间、术中透视时间、导针调整次数、螺钉置入位置优良率和不良事件发生率进行统计分析,评价机器人辅助骨盆和髋臼骨折进行经皮螺钉内固定治疗的有效性和安全性。结果:试验组7例患者共置入11枚螺钉,对照组5例患者共置入7枚螺钉。术后CT透视检查确认所有螺钉位置均满意,但两组螺钉的分布差异有统计学意义(P=0.016),试验组优率高于对照组;试验组平均螺钉置入所需透视时间为(7.36±2.63)s,短于对照组的(41.80±13.99)s,差异有统计学意义(P0.001);试验组术中平均螺钉调整次数为(0.36±0.48)次,少于对照组的(9.00±3.06)次,两组差异具有统计学意义(P=0.003);试验组平均手术时间为(43.86±49.06)min,对照组为(29.00±12.14)min,两组差异无统计学意义(P=0.528)。进行CT透视确认所有螺钉位置满意,未见穿出骨皮质及进入关节腔者,未见伤口感染等其他螺钉置入的相关并发症发生。结论:外科手术机器人适用于辅助进行骨盆和髋臼骨折经皮螺钉内固定治疗,并具有置入准确性高、透视辐射小、安全有效等优点。
[Abstract]:Objective: to evaluate the safety and efficacy of robot assisted percutaneous screw fixation in the treatment of pelvic and acetabular fractures. Methods: twelve patients with pelvic and acetabular fractures admitted in Department of Orthopedics, Beijing Jishuitan Hospital from January to April 2016 were randomly divided into two groups: experimental group and control group. Seven patients in the test group were operated by a robot assisted doctor, and 5 patients in the control group were operated by a doctor with bare hands guided by fluoroscopy. The total time of operation, the time of fluoroscopy during operation and the times of adjusting the guide needle were used in the two groups. The excellent and good rate of screw placement and the incidence of adverse events were statistically analyzed to evaluate the efficacy and safety of robot assisted percutaneous screw fixation for pelvic and acetabular fractures. Results: 11 screws were implanted in 7 patients in test group and 7 screws in 5 patients in control group. Postoperative CT fluoroscopy confirmed that all screw positions were satisfactory, but the distribution of screws in the two groups was significantly different (P0. 016), and the excellent rate in the trial group was higher than that in the control group. The average fluoroscopy time of the test group was (7.36 卤2.63) s, shorter than that of the control group (41.80 卤13.99) s, the difference was statistically significant (P0.001). The average times of screw adjustment were (0.36 卤0.48) times in the experimental group, less than (9.00 卤3.06) times in the control group. The difference between the two groups was statistically significant (P0. 003). The mean operation time of the trial group was (43.86 卤49.06) min, control group was (29.00 卤12.14) min, there was no significant difference between the two groups (P0. 528). CT fluoroscopy was performed to confirm the satisfactory position of all screws. No complications such as wound infection and other screw implantation were found in the patients who had not perforated the bone cortex or entered the articular cavity. Conclusion: the surgical robot is suitable for assisted percutaneous screw fixation of pelvic and acetabular fractures, and has the advantages of high accuracy, low fluoroscopy and safety and effectiveness.
【作者单位】： 北京积水潭医院创伤骨科;
【基金】：科技部国家重点研发计划项目(2016YFC0105802)资助~~
【分类号】：R687.3;TP242
本文编号：2391300
[Abstract]:Objective: to evaluate the safety and efficacy of robot assisted percutaneous screw fixation in the treatment of pelvic and acetabular fractures. Methods: twelve patients with pelvic and acetabular fractures admitted in Department of Orthopedics, Beijing Jishuitan Hospital from January to April 2016 were randomly divided into two groups: experimental group and control group. Seven patients in the test group were operated by a robot assisted doctor, and 5 patients in the control group were operated by a doctor with bare hands guided by fluoroscopy. The total time of operation, the time of fluoroscopy during operation and the times of adjusting the guide needle were used in the two groups. The excellent and good rate of screw placement and the incidence of adverse events were statistically analyzed to evaluate the efficacy and safety of robot assisted percutaneous screw fixation for pelvic and acetabular fractures. Results: 11 screws were implanted in 7 patients in test group and 7 screws in 5 patients in control group. Postoperative CT fluoroscopy confirmed that all screw positions were satisfactory, but the distribution of screws in the two groups was significantly different (P0. 016), and the excellent rate in the trial group was higher than that in the control group. The average fluoroscopy time of the test group was (7.36 卤2.63) s, shorter than that of the control group (41.80 卤13.99) s, the difference was statistically significant (P0.001). The average times of screw adjustment were (0.36 卤0.48) times in the experimental group, less than (9.00 卤3.06) times in the control group. The difference between the two groups was statistically significant (P0. 003). The mean operation time of the trial group was (43.86 卤49.06) min, control group was (29.00 卤12.14) min, there was no significant difference between the two groups (P0. 528). CT fluoroscopy was performed to confirm the satisfactory position of all screws. No complications such as wound infection and other screw implantation were found in the patients who had not perforated the bone cortex or entered the articular cavity. Conclusion: the surgical robot is suitable for assisted percutaneous screw fixation of pelvic and acetabular fractures, and has the advantages of high accuracy, low fluoroscopy and safety and effectiveness.
【作者单位】： 北京积水潭医院创伤骨科;
【基金】：科技部国家重点研发计划项目(2016YFC0105802)资助~~
【分类号】：R687.3;TP242
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