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外科研究与新技术(中英文) ›› 2025, Vol. 14 ›› Issue (2): 117-121.doi: 10.3969/j.issn.2095-378X.2025.02.004

• 论著 • 上一篇    下一篇

3D打印+急诊外侧入路手术治疗创伤性跟骨骨折对患者应激和炎症因子水平的影响

何祎, 唐杰   

  1. 西部战区空军医院骨科, 四川 成都 610011
  • 收稿日期:2024-10-10 出版日期:2025-06-28 发布日期:2025-07-07
  • 通讯作者: 唐 杰,电子信箱:hejianjunsz76@163.com

Effects of 3D printing and emergency lateral approach surgery on stress and inflammatory factors in patients with traumatic calcaneal fractures

HE Yi, TANG Jie   

  1. Department of Orthopedics, Air Force Hospital of Western Theater Command, Chengdu 610011, Sichuan, China
  • Received:2024-10-10 Online:2025-06-28 Published:2025-07-07

摘要: 目的 探讨3D打印结合急诊外侧入路手术治疗创伤性跟骨骨折对患者应激反应和炎症因子的影响。方法 研究对象为2021年2月—2024年2月期间收治的126例创伤性跟骨骨折患者,按照信封法随机分为观察组与对照组,每组各63例。对照组接受传统X射线辅助下的急诊外侧入路手术治疗,观察组接受3D打印+急诊外侧入路手术治疗,比较两组在术前、术后的血清炎症因子、应激指标、影像学参数及末次随访时踝关节功能差异。结果 与手术前相比,术后1 d的白细胞介素-6(IL-6)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)与皮质醇(Cor)均提高,但观察组的提升幅度小于对照组(P<0.05)。与手术前相比,术后1周的Bohler角与Gissane角均显著提高,且观察组的提升幅度大于对照组(P<0.05);跟骨宽度与跟骨长度在手术前与术后1周的差异均无统计学意义(P>0.05);两组术后1周的跟骨高度均显著大于手术前(P<0.05),但两组间差异无统计学意义(P>0.05);末次随访时,观察组踝关节功能优良率明显高于对照组,差异具有统计学意义(P<0.05)。结论 3D打印结合急诊外侧入路手术治疗创伤性跟骨骨折患者,有利于使临床医生熟悉手术操作,从而减少术后炎症因子和应激反应,改善影像学参数与踝关节功能。

关键词: 3D打印, 急诊外侧入路手术, 创伤性跟骨骨折, 炎症应激因子

Abstract: Objective To investigate the effects of 3D printing combined with emergency lateral approach surgery on stress response and inflammatory factors in patients with traumatic calcaneal fractures. Methods The research subjects were 126 patients with traumatic calcaneal fractures admitted from February 2021 to February 2024. They were randomly divided into an observation group and a control group using the envelope method, with 63 patients in each group. The control group received emergency lateral approach surgery with traditional X-ray assistance, while the observation group received 3D printing+emergency lateral approach surgery. The differences in serum inflammatory factors, stress indicators, imaging parameters, and ankle joint function at the final follow-up were compared between the two groups. Results Compared with before surgery, the interleukin-6 (IL-6), C reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and cortisol (Cor) all increased on postoperative day 1, but the increase in the observation group was smaller than that in the control group (P<0.05). Compared with before surgery, the Bohler angle and Gissane angle significantly increased one week after surgery, and the increase in the observation group was greater than that in the control group (P<0.05). There was no statistically significant difference in calcaneal width and calcaneal length before and 1 week after surgery (P>0.05). The calcaneal height of both groups one week after surgery was significantly higher than that before surgery (P<0.05), but there was no statistical difference between the two groups (P>0.05). At the final follow-up, the excellent and good rate of ankle joint function in the observation group was significantly higher than that in the control group (P<0.05). Conclusion The application of 3D printing combined with emergency lateral approach surgery for patients with traumatic calcaneal fractures enables clinicians to become more familiar with the surgical procedure, thereby reducing postoperative inflammatory factors and stress response, and enhancing imaging parameters and ankle joint function.

Key words: 3D printing, Emergency lateral approach surgery, Traumatic calcaneal fracture, Inflammatory and stress factors

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