摘要
目的 回顾性分析骨科机器人引导经皮空心钉内固定对骨盆骨折患者的临床疗效。方法 研究对象为2023年1月~2024年12月在湖北医药学院附属医院太和医院创伤骨科治疗的骨盆骨折患者182例,以随机数字表法分为观察组(n=91)及对照组(n=91),两组均采用经皮空心钉内固定治疗,观察组联合骨科机器人引导,比较两组患者的骨盆复位情况,血清学指标[血过氧化物酶体增殖物激活受体γ共激活因子1α(PGC-1α)、碱性磷酸酶(ALP)、D-二聚体(D-D)],手术相关指标,疼痛评分,骨盆功能及远期并发症发生率。结果 手术6个月后,观察组患者骨盆复位总优良率较对照组高(P<0.05);出院前,两组患者PGC-1α、ALP均升高,且观察组较对照组高(P<0.05),D-D均降低,且观察组较对照组低(P<0.05);观察组患者手术置钉时间,螺钉置入时间,手术时间,切口长度,住院时间及骨折愈合时间均较对照组短(P<0.05),术中透视次数和术中出血量较对照组少(P<0.05),螺钉置入准确率较对照组高(P<0.05);手术后12 h、3 d、7 d,两组患者视觉模拟量表(VAS)评分均较手术前降低,且观察组较对照组低(P<0.05);手术6个月后,观察组患者骨盆功能恢复情况优于对照组(P<0.05);观察组患者远期并发症发生率较对照组低(P<0.05)。结论 骨科机器人引导经皮空心钉内固定可促进骨盆骨折患者的骨盆复位,同时促进骨折愈合及骨盆功能的恢复,提高螺钉置入准确率,调节骨代谢,改善机体高凝状态,减轻疼痛,减少远期并发症的发生。
Objective To analyze the clinical efficacy of orthopedic robot-guided percutaneous cannulated screw internal fixation on patients with pelvic fractures retrospectively.Methods Totally 182 patients with pelvic fractures who were treated in Department of Traumatic Orthopedics of Taihe Hospital,Affiliated Hospital of Hubei University of Medicine from January 2023 to December 2024,were divided into observation group(n=91)and control group(n=91)by random number table method.Both groups were treated with percutaneous cannulated screw internal fixation,and the observation group was combined with orthopedic robot guidance.The pelvic reduction status,serological indicators[serum peroxisome proliferator-activated receptorγcoactivator-1α(PGC-1α),alkaline phosphatase(ALP),D-dimer(D-D)],surgeryrelated indicators,pain score,pelvic function and incidence rates of long-term complications were compared between the two groups of patients.Results After 6 months of surgery,the total excellent and good rate of pelvic reduction of patients in observation group was higher than that in control group(P<0.05).Before discharge,the levels of PGC-1αand ALP in the two groups increased,and the levels in observation group were higher than those in the control group(P<0.05),and D-D level decreased,and the level in observation group was lower(P<0.05).The surgical screw placement time,screw placement time,surgical time,incision length,hospitalization time and fracture healing time in observation group were shorter compared to the control group(P<0.05),and the intraoperative fluoroscopy frequency and intraoperative blood loss volume were less(P<0.05),and the accuracy rate of screw placement was higher than that in the control group(P<0.05).On 12 hours,3 days and 7 days after surgery,the visual analogue scale(VAS)scores in the two groups of patients were reduced compared with that before surgery,and the score was lower in the observation group(P<0.05).The recovery of pelvic function in observation group after 6 months of surgery was better than that in the control group(P<0.05).The observation group had lower incidence rates of long-term complications than the control group(P<O.05).Conclusion Orthopedic robot-guided percutaneous cannulated screw internal fixation can promote the pelvic reduction in patients with pelvic fractures,while also promoting the fracture healing and pelvic function recovery,improving the accuracy rate of screw placement,regulating the bone metabolism,improving the body's hypercoagulable state,reducing pain,and minimizing the occurrence of long-term complications.
作者
周小锐
张劲松
杨健
尚锋
ZHOU Xiao-rui;ZHANG Jin-song;YANG Jian;SHANG Feng(Department of Traumatic Orthopedics,Shiyan Taihe Hospital(Affiliated Hospital of Hubei University of Medicine),Hubei Shiyan 442000,China)
出处
《解剖学报》
2026年第1期48-57,共10页
Acta Anatomica Sinica
关键词
骨科机器人引导经皮空心钉内固定
骨盆骨折
骨盆复位
D-二聚体
回顾性分析
人
Orthopedic robot-guided percutaneous cannulated screw internal fixation
Pelvic fracture
Pelvic reduction
D-dimer
Retrospective analysis
Human
