摘要目的 探讨运用3D打印导航模块技术联合自体松质骨及异体腓骨对于治疗早期股骨头坏死的临床疗效。方法 选取我院2016年1月至2018年8月收治股骨头坏死国际骨循环研究会(the association research circulation osseous，ARCO)分期为Ⅰ、Ⅱ期的26例患者为研究对象，根据患者随机自愿选择分为3D打印导航模块辅助髓芯减压植骨组和传统减压植骨组。统计分析传统髓芯减压组与3D打印导航模块辅助减压组在术前及术后Harris评分、手术时间、手术切口长度、术后引流量及术中透视频次等相关临床数据。结果 全部病例均获得随访，随访时间1~24个月，平均(9.83±2.34)个月。临床资料统计分析发现两组手术方式术前及术后Harris评分差异均有统计学意义(P＜0.05)，基线资料比较差异无统计学意义(P＞0.05)；3D打印组和传统手术组在手术时间和术中透视频次方面差异有统计学意义(P＜0.05)，而在术后血浆引流量及切口长度方面差异无统计学意义(P＞0.05)。结论 3D打印导航模块技术辅助髓芯减压植骨较传统减压植骨手术临床效果较好，能提高患者生活质量及预后，在缩短手术时间及减少术中透视次数方面有明显优势，值得临床推广运用。
Abstract：Objective To explore the efficacy of employing 3D printing technique combined with allogeneic fibula to treat early stage necrosis of femur head.Methods Materials of 26 patients admitted to our department between January 2016 and August 2018 with images classification of stage Ⅰand stageⅡ according to Association Research Circulation Osseous classification were categorized into 3D printing group and conventional non-3D printing group based on the type of surgery procedure.The factors of Harris scores before and afteroperation，intraoperation time，incision length，drainage and X-ray frequency were meticulously collected and statistically analysed.Results All patients were followed up and the follow-up duration were (9.83±2.34)months (range1 to 24 ).Statistical analyses showed that the Harris scores before operation and after operationofthe two groups hadsignificant differences(P＜0.05)，but the baselines between the two groups were actually the same with no significant differences.We also found that operation time and X-ray frequency were different between the 3D pringting group and non-3D conventional group(P＜0.05)，but the drainage volume and incision length hadnostatistically differences (P＞0.05).Conclusion 3D printingassisted navigation technique systems could have the same comparatively clinic outcomes and efficacy to non-3D conventional groups for the treatment of early stage of femur head necrosis，and can improve the quality of patient life，prevent the progression of femur head necrosis and improve the prognosis of these disease，and advantages of this technique in shortening operation time and reducing X-ray frequency are also apparent.Thus，this 3D printing mould assisted technique should be promoted and utilized in clinic and could make benefit to the patients.
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