摘要
目的探讨天玑骨科手术机器人结合三维成像技术辅助微创手术治疗骨盆骨折的疗效。方法回顾性分析2019年1月至2021年5月广东省阳江市人民医院创伤骨科收治的40例以S1及S2骶髂关节螺钉固定的骨盆骨折患者资料,根据治疗方法不同分为两组:机器人组(采用天玑骨科手术机器人辅助经皮置入骶髂关节螺钉固定)20例,男13例,女7例;年龄为(38.2±8.8)岁。徒手组(采用普通C型臂X线机透视下徒手置入骶髂关节螺钉固定治疗)20例,男11例,女9例;年龄为(37.3±9.2)岁。记录并比较两组患者螺钉置入所用透视时间、导针调整次数、手术时间、术中出血量、术后72 h疼痛视觉模拟评分、术后住院时间、下地活动时间、螺钉置入优良率、并发症发生率、骨折愈合时间、术后6个月Majeed评分、功能评价优良率。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。机器人组螺钉置入透视时间[(8.2±2.9)s]、导针调整次数[(0.4±0.2)次]、手术时间[(67.4±5.5)min]、术中出血量[(36.5±8.0)mL]显著少于徒手组[(40.4±4.5)s、(8.6±0.7)次、(78.4±7.2)min、(41.6±7.8)mL],疼痛视觉模拟评分[3.0(4.0,5.0)分]显著低于徒手组[4.0(5.0,6.0)分],螺钉置入位置优良率(100%,40/40)显著高于徒手组(85.0%,34/40),并发症发生率(5.0%,1/20)显著低于徒手组(35.0%,7/20),以上比较差异均有统计学意义(P<0.05);两组患者术后住院时间、下地活动时间、骨折愈合时间、Majeed评分、功能评价优良率比较差异均无统计学意义(P>0.05)。结论与徒手置入骶髂关节螺钉固定比较,天玑骨科手术机器人结合三维成像技术辅助微创手术治疗骨盆折效果确切,可以减少辐射暴露、手术时间、出血量、并发症发生率,提高螺钉置入准确率,增加安全性。
Objective To explore the efficacy and safety of TiRobot combined with three-dimensional imaging in the minimally invasive surgery for pelvic fractures.Methods A retrospective analysis was conducted of the 40 patients with pelvic fracture who had been treated by fixation with S1 and S2 sacroiliac screws at Department of Orthopaedics and Traumatology,Yangjiang People's Hospital from January 2019 to May 2021.They were divided into 2 groups according to their treatment methods.In the TiRobot group of 20 cases subjected to percutaneous sacroiliac screw fixation assisted by TiRobot combined with three-dimensional imaging,there were 13 males and 7 females with an age of(38.2±8.8)years.In the manual group of 20 cases subjected to fixation with manual placement of sacroiliac screws under conventional C-arm fluoroscopy,there were 11 males and 9 females with an age of(37.3±9.2)years.The 2 groups were compared in terms of fluoroscopy time for screw placement,guide needle adjustment,operation time,intraoperative blood loss,visual analogue scale(VAS)72 hours after operation,postoperative hospital stay,time to ambulation,excellent to good rate of screw placement,complication rate,fracture union time,Majeed score at 6 months after operation,and excellent to good rate of functional evaluation.Results There was no significant difference between the 2 groups in their preoperative general data,showing they were comparable(P>0.05).In the TiRobot group,fluoroscopy time for screw placement[(8.2±2.9)s],guide needle adjustment[(0.4±0.2)times],operation time[(67.4±5.5)min],and intraoperative blood loss[(36.5±8.0)mL]were significantly less than those in the manual group[(40.4±4.5)s,(8.6±0.7)times,(78.4±7.2)min,and(41.6±7.8)mL],postoperative VAS[3.0(4.0,5.0)points]was significantly lower than that in the manual group[4.0(5.0,6.0)points],the excellent to good rate of screw placement(100%,40/40)was significantly higher than that in the manual group(85.0%,34/40),and the complication rate(5.0%,1/20)was significantly lower than that in the manual group(35.0%,7/20)(all P<0.05).There was no significant difference between the 2 groups in postoperative hospital stay,time to ambulation,fracture union time,Majeed score,or excellent to good rate of functional evaluation(P>0.05).Conclusion In the minimally invasive surgery for pelvic fractures,TiRobot combined with three-dimensional imaging leads to positive outcomes,because it can reduce operation time and radiation exposure,improve accuracy of screw placement,and increase safety.
作者
王永标
冯小仍
姚艺艺
林进标
郑进发
关炼雄
李宇鹏
骆兆配
赵文雅
Wang Yongbiao;Feng Xiaoreng;Yao Yiyi;Lin Jinbiao;Zheng Jinfa;Guan Lianxiong;Li Yupeng;Luo Zhaopei;Zhao Wenya(Department of Orthopaedics and Traumatology,Yangjiang People's Hospital,Yangjiang 529500,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第10期856-861,共6页
Chinese Journal of Orthopaedic Trauma
基金
广东省医学科学技术研究基金项目(A2021307)。
关键词
骨盆
骨折
外科手术
微创性
骨科手术机器人
三维成像
安全性
Pelvis
Fractures,bone
Surgical procedures,minimally invasive
TiRobot
Three-dimensional imaging technology
Safety
