北京生物医学工程

骨科机器人辅助手术治疗骨盆骨折的临床应用研究

The clinical effects of robot-assisted orthopedic surgery on pelvic fracture patients

单位：佛山市中医院骨科（广东佛山 528000） 通信作者：吴征杰。E-mail: 13902414988@163.com

分类号： R318

出版年·卷·期（页码）：2022·41·2（134-139）

摘要：

目的探讨骨科机器人辅助手术治疗骨盆骨折的具体临床应用效果。方法回顾性收集2018年2月至2019年7月于佛山市中医院行微创手术治疗的Tile B、C型骨盆骨折患者112名。根据手术方式将患者分为骨科机器人辅助微创手术组和传统透视辅助微创手术组。对比两组患者的术中出血量、手术时间、置钉时间、螺钉非计划置入比例、位置偏移率、骶髂螺钉置入误差范围以及螺钉位置偏移程度。术后比较两组患者Matta评分比较两组复位质量，末次Majeed评分比较两组患者的功能以及并发症的发生情况。结果两组患者基线资料显示无明显统计学差异（P>0.05）。骨科机器人辅助微创手术组术中出血量、手术时间、置钉时间、螺钉偏移位置以及骶髂螺钉置入误差范围都明显少于传统透视辅助微创手术组，差异性具有统计学意义（P<0.05)。术后结果对比分析显示，骨科机器人辅助微创手术组术后满意率、功能恢复情况都明显优于传统透视辅助微创手术组（P<0.05)。同时，骨科机器人辅助微创手术组术后并发症的发生率明显低于传统透视辅助微创手术组（P<0.05)。两组患者术后螺钉位置偏移程度以及螺钉非计划置入数无明显统计学差异（P>0.05)。结论骨科机器人辅助手术针对不稳定型骨盆骨折患者具有良好的临床应用效果。

Objective To determine the clinical effects of robot-assisted orthopedic surgery technique on pelvic fracture patients. Methods This is a retrospective study. From Feb. 2018 to July 2019, a total of 112 tile B and tile C type of orthopedic fracture patients in Foshan Hospital of Traditional Chinese Medicine underwent minimally invasive orthopedic surgery were included into this study. According to the surgery techniques, patients were divided to robot-assisted orthopedic surgery group and traditional orthopedic surgery group. Intraoperative indicators including intraoperative blood loss, operating time, nail placement time, the proportion of unplanned screw placement, the position deviation rate, the error range of sacroiliac screw placement and screw position deviation degree were recorded and compared between groups. Postoperatively, Matta score, Majeed score and complication happened were compared between groups. Results The baseline characteristics comparison showed no significant difference between groups (P>0.05). The intraoperative indicators showed that intraoperative blood loss, operating time, nail placement time, the proportion of unplanned screw placement, the position deviation rate and the error range of sacroiliac screw placement in robot-assisted orthopedic surgery group were all superior to the traditional orthopedic surgery group with significance (P<0.05). At postoperative comparisons, the Matta scores and Majeed scores at the robot-assisted orthopedic surgery group showed better results than traditional orthopedic surgery group with significance (P <0.05). The complication occurrence rate was significantly lower at robot- assisted orthopedic group when compared to traditional orthopedic group. (P<0.05). There showed no significant difference between groups in screw position deviation degree and unplanned screw placement (P>0.05). Conclusions Robot-assisted orthopedic surgery can be an effective way to treat unstable pelvic fracture with preferable clinical effects.

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