摘要目的:探讨3D打印导板技术在全髋关节置换术（THA）髋臼假体精准置入中的应用效果。方法:回顾性分析2017年8月至2020年1月期间湖北省孝感市第一人民医院骨科采用THA治疗的56例（60髋）股骨颈骨折或股骨头缺血性坏死患者资料。根据是否应用3D打印导板技术及操作医生资历分为3组（ n=20）：A组男9髋，女11髋；年龄为（60.0±8.0）岁；应用3D打印导板并由中年资主治医师手术。B组男13髋，女7髋；年龄为（61.5±8.5）岁；不应用3D打印导板但由高年资副主任医师手术。C组男11髋，女9髋；年龄为（66.2±9.9）岁；应用3D打印导板并由高年资副主任医师手术。比较3组患者的手术时间、术中出血量、术后1周前倾角和外展角、并发症发生情况及患髋功能等。 结果:3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。A组、C组患者的手术时间[（32.4±4.4）、（31.9±4.9）min]显著短于B组患者[（39.7±5.0）min]，术中出血量[（332.2±44.9）、（319.8±44.1）mL]显著少于B组患者[（419.1±45.9）mL]；术后1周前倾角（15.6°±2.0°、15.0°±1.9°）、外展角（45.6°±1.9°、45.1°±1.9°）显著小于B组患者（18.9°±2.0°、49.1°±1.9°），差异均有统计学意义（ P<0.05）。C组患者术后3个月髋关节Harris评分[（97.3±1.9）分]显著高于A组、B组患者[（88.2±2.3）、（87.0±2.0）分]，差异均有统计学意义（ P<0.05）。术后3个月内无一例患者发生神经损伤、深静脉血栓形成及假体脱位等并发症。 结论:3D打印导板技术应用于THA髋臼假体精准置入能够缩短患者手术时间、减少术中出血量，促进患者患髋功能恢复。

abstractsObjective:To evaluate the application of a 3D printed guide plate for precise placement of acetabular prosthesis in total hip replacement.Methods:From August 2017 to January 2020, 56 patients (60 hips) underwent total hip replacement at Department of Orthopaedics, Xiaogan First People's Hospital for femoral neck fracture or avascular necrosis of the femoral head. They were randomly divided into 3 even groups ( n=20 hips). In group A (11 male and 9 female hips) with an age of 60.0 years ± 8.0 years, the 3D printed guide plate was used in the surgery performed by doctors in charge with an intermediate professional rank; in group B (13 male and 7 female hips) with an age of 61.5 years ± 8.5 years, the 3D printed guide plate was not used but surgery was performed by associate chief doctors with a senior professional rank; in group C (11 male and 9 female hips) with an age of 66.2 years ± 9.9 years, the 3D printed guide plate was used in the surgery performed by associate chief doctors with a senior professional rank. The 3 groups were compared in terms of operation time, intraoperative bleeding, complications and function of affected hip. Results:There was no significant difference in the preoperative general data between the 3 groups, showing comparability ( P>0.05). The operation time (32.4 min ± 4.4 min and 31.9 min ± 4.9 min), intraoperative bleeding (332.2 mL ± 44.9 mL and 319.8 mL ± 44.1 mL), anteversion (15.6°±2.0° and 15.0°±1.9°) and abduction (45.6°±1.9° and 45.1°±1.9°) at postoperative one week for groups A and C were significantly less or lower than those for group B (39.7 min ± 5.0 min, 419.1 mL ± 45.9 mL, 18.9°±2.0°, and 49.1°±1.9°, respectively)( P<0.05) while the Harris hip scores at 3 postoperative months for group C (97.3±1.9) significantly higher than those for groups A and B (88.2±2.3 and 87.0±2.0)( P<0.05). No patient had such complications as nerve injury, deep vein thrombosis or prosthesis dislocation within 3 months after surgery. Conclusion:Application of a 3D printed guide plate for precise placement of acetabulum prosthesis in total hip replacement can shorten operation time, reduce intraoperative bleeding and enhance functional recovery of the affected hip.