CAJ | 학술논문

背景：计算机技术已经实现了从二维图像到三维图像的飞跃，加上与快速成型术的完美结合，使临床医师可以准确判断骨折部位和制定手术计划。术前骨折复位模拟明显提高了手术的安全性和手术的质量。 　　目的：评价计算机辅助在骨盆骨折诊断与治疗方面的临床价值。 　　方法：收集20例骨盆骨折患者，随机分成计算机辅助组和传统手术组。传统手术仅行骨盆 X 射线片和二维CT扫描，计算机辅助组提取CT原始数据，利用MIMICS软件进行三维重建，通过快速成型技术按照1∶1比例制作骨盆和钢板模型。术者及手术参与人员术前进行骨折复位仿真模拟训练，重建过程中记录手术时间和术中出血量，与传统手术进行比较。 　　结果与结论：重建过程中所见与术前制作的三维骨盆骨折模型非常相似，术前的演练使术中参与者配合更默契，操作更迅速，更精确。计算机辅助组患者均获得良好的骨折复位，术中钢板的折弯更伏贴骨质，钢钉的长度更合适，位置更佳。与传统手术相比较，计算机辅助手术术中出血量更少，手术时间更短，差异有显著性意义(P<0.05)。计算机辅助临床手术具有创伤小、更精确的特点，对患者和医疗人员更加安全，它在骨科及其他科室手术中有着广阔的应用前景。
배경：계산궤기술이경실현료종이유도상도삼유도상적비약，가상여쾌속성형술적완미결합，사림상의사가이준학판단골절부위화제정수술계화。술전골절복위모의명현제고료수술적안전성화수술적질량。 　　목적：평개계산궤보조재골분골절진단여치료방면적림상개치。 　　방법：수집20례골분골절환자，수궤분성계산궤보조조화전통수술조。전통수술부행골분 X 사선편화이유CT소묘，계산궤보조조제취CT원시수거，이용MIMICS연건진행삼유중건，통과쾌속성형기술안조1∶1비례제작골분화강판모형。술자급수술삼여인원술전진행골절복위방진모의훈련，중건과정중기록수술시간화술중출혈량，여전통수술진행비교。 　　결과여결론：중건과정중소견여술전제작적삼유골분골절모형비상상사，술전적연련사술중삼여자배합경묵계，조작경신속，경정학。계산궤보조조환자균획득량호적골절복위，술중강판적절만경복첩골질，강정적장도경합괄，위치경가。여전통수술상비교，계산궤보조수술술중출혈량경소，수술시간경단，차이유현저성의의(P<0.05)。계산궤보조림상수술구유창상소、경정학적특점，대환자화의료인원경가안전，타재골과급기타과실수술중유착엄활적응용전경。
BACKGROUND:The rapid development of computer technology has realized the leap from two-dimensional image to three-dimensional image. With the perfect combination of the rapid prototyping technique, the clinician can accurately judge the fracture location and draw up a plan of operation. Preoperative fracture reduction and simulation obviously improve the safety and quality of the operation. OBJECTIVE:To evaluate the clinical value of computer-aided technology in diagnosis and treatment of pelvic fracture. METHODS:We col ected 20 patients with pelvic fractures, who were randomly divided into the computer-aided group and the traditional surgery group. Traditional surgical method only needed X-ray and two-dimensional CT scanning of pelvis. Computer-aided group needed to extract original CT data, used MIMICS software for three-dimensional reconstruction. The models of pelvic and steel plate were made using rapid prototyping technique according to the proportion of 1:1. Performers and participants completed surgical simulation training before the operation. Time used in surgery and volume of blood loss during operation were recorded, and compared with the traditional surgery. RESULTS AND CONCLUSION:What seen in the operation was very similar to what seen from the preoperative model of pelvic fracture. The preoperative practice made participants more tacit understanding, resulting in operating quicker and more accurate. Al patients of computer-aided group got good fracture reduction, intraoperative steel plate bending more fitting for bone, the length of the steel nail was more appropriate, the location was better. Compared with traditional surgery, computer-assisted surgery had less blood loss, shorter operation time and more statistical y significant difference (P<0.05). Computer-aided clinical surgery has characteristics of smal trauma, more accurate, more safety for patients and medical staffs, and has broad application prospects in orthopedics and other departments.