计算机辅助渐进成型技术在颅骨修复术中的应用  

Application on cranioplasty of computer-aided gradually-forming technique

作　　者：李京生[1] 孙涛[1] 陆峥[1] 刘伯运[1] 赵元立[1] 赵书礼[1] 李彦生[2] 宫剑[1] 田永吉[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]北京工业大学

出　　处：《北京医学》2008年第4期202-204,共3页Beijing Medical Journal

基　　金：国家自然科学基金资助项目(30500520)

摘　　要：目的评价采用计算机辅助设计及渐进成型技术塑形的钛网板在神经外科颅骨修复术中的应用效果。方法首先基于患者头颅CT数据进行三维重建,基于重建模型设计修复体,然后采用快速成型技术制作修复体的实物模型,比照实物模型采用渐进成型技术压制钛网板,剪边后得到最终的修复体,并实施常规手术修复。结果行颅骨修复127例,平均手术时间为(127.21±27.77)min,比传统手工塑形手术时间[(159.95±43.34)min]缩短约30min。术后皮下积液5例,硬膜下出血1例。塑形后的钛修复体表面光滑,曲度自然,边缘与缺损处贴合良好。术后患者头颅外形美观,双侧对称。术后随访110例,随访时间4～29个月,平均13个月。无伤口感染、钛板脱落移位及头皮慢性切割破损等远期并发症。结论采用计算机辅助设计和渐进成型技术塑形的钛修复体与传统手工塑形相比,具有手术步骤简便、塑形的钛修复体曲度自然、非常接近原颅骨外形、术中无需再加工、术后并发症少等优点,值得在颅骨缺损修复中推广应用。Objective To evaluate the application of computer-aided gradually-forming titanium plate on cranioplasty. Methods Firstly, three dimension （3D） reconstruction in computer was performed on the basis of the patient’s cranial CT and 3D reconstructed model. Secondly, the solid model by the rapid prototyping technique was made and the titanium plate with the gradually-forming technique according to the solid model was prothesis. Then, the final prothesis was trimmed and routine surgical repair was performed. Results Cranioplasty was performed in 127 patients with the average surgical time of （127.21±27.77）min. Compared with traditional manual shaping, it was significantly decreased of 30 minutes. After operation subcutaneous hydrops occurred in 5 patients and subdural hemorrhage occurred in one patient. The shapes of titanium prothesis were smooth and with natural curve. The appearances of cranium looked beautiful and symmetric. No other complications occurred, such as infectious wound, titanium plate shift or chronic scalp-incision. Conclusions Compared with the conventional manual shaping, the titanium prothesis shaped by computer-aid gradually-forming technique has many advantages such as simple and convenient operational steps, natural curve which is similar to the shape of the original cranium, no need of intraoperative reshaping and few complications. This technique has advantages of low-cost and simple surgical steps. It is quite worth of spreading and applying.

关 键 词：颅骨缺损 颅骨修复术 计算机辅助设计 渐进成型 

分 类 号：R651[医药卫生—外科学]