64层螺旋CT联合三维重建在股骨颈骨折治疗方案选择和预后评估中的价值
Value of 64-slice spiral CT combined with three-dimensional reconstruction in the treatment selection and prognosis evaluation of femoral neck fracture
高艳 1潘小文 1董晚亭 1肖鹏2
作者信息
- 1. 四川省骨科医院 医学影像科 四川 成都 610041
- 2. 四川省骨科医院 骨科 四川 成都 610041
- 折叠
摘要
目的:探讨 64层螺旋CT联合三维重建在股骨颈骨折(FNF)治疗方案选择和预后评估中的价值.方法:回顾性分析2020年1-10月收治的180例FNF患者,随机数字表法分为观察组(90例)和对照组(90例),随访2年,根据预后是否良好分为预后良好组(83例)和预后不良组(7例).Logistic分析影响预后的因素;拟合曲线、阈值效应分析CT扫描联合三维重建与预后的关系;构建风险评分模型并评价其效能.结果:观察组诊断符合率明显高于对照组(P<0.05);年龄>60岁、车祸受伤和重物砸伤、Garden分型Ⅲ型和Ⅳ型、头下型、骨折线倾斜角度分型Ⅲ型、Garden指数Ⅲ级和Ⅳ级、骨折闭合内固定术、手术前未牵引、手术时间>72 h为预后不良的危险因素(P<0.05).Garden分型降低,预后不良可能性下降.高危组不良反应发生率明显高于低危组和中危组(P<0.001).风险预测模型的区分度、准确度较高.结论:64层螺旋CT联合三维重建可减少手术时间,优化骨折复位效果,减少术后不良反应.
Abstract
Objective:To evaluate the value of 64-slice spiral CT combined with three-dimensional recon-struction in the treatment and prognosis of femoral neck fracture(FNF).Methods:A total of 180 pa-tients with FNF admitted to the hospital from January to October 2020 were retrospectively analyzed.Patients were randomly divided into the observation group(90 cases)and control group(90 cases).Af-ter two years of follow-up,they were divided into a good prognosis group(83 cases)and a poor progno-sis group(7 cases)according to whether the prognosis was good or not.Logistic analysis of prognostic factors;fitting curve and threshold effect analysis were adopted to study the relationship between CT scanning combined with three-dimensional reconstruction results and the patient's prognosis.A risk score model was constructed and its efficacy was evaluated.Results:The age>60 years,traffic acci-dent injury and heavy object injury,Garden type Ⅲ and Ⅳ,subcephalic type,fracture line tilt angle type Ⅲ,Garden index Ⅲ grade and Ⅳ grade,closed internal fixation of fracture,no traction before op-eration and operation time>72 hours were the risk factors of poor prognosis.Higher Garden classifica-tion levels were related to the poor prognosis.The incidence of adverse reactions in high-risk group was significantly higher than that in the low-risk group and medium-risk group(P<0.001).The differ-entiation rate and accuracy of the risk prediction model are high.Conclusion:The 64-slice spiral CT combined with three-dimensional reconstruction applied before operation can effectively reduce the op-eration time,optimize the effect of fracture reduction,and reduce postoperative adverse reactions.
关键词
64层螺旋CT/三维重建/股骨颈骨折/治疗/预后Key words
64-Slice Spiral CT/Three-Dimensional Reconstruction/Femoral Neck Fracture/Treatment/Prognosis引用本文复制引用
基金项目
四川省中医药管理局科学技术研究专项课题(2020JC0097)
出版年
2024
NETL
NSTL
万方数据