应用3D打印技术修复肋骨缺损的可行性研究  

Feasibility study on application of 3D printing technology in rib defect repair

作　　者：温小鹏[1] 高山[1] 李硕[1] 付军科[1] 张广健[1] 

机构地区：[1]西安交通大学第一附属医院胸外科,陕西西安710061

出　　处：《现代肿瘤医学》2017年第20期3252-3256,共5页Journal of Modern Oncology

基　　金：陕西设计发展科技攻关项目(编号:2016SF-069)

摘　　要：目的:验证3D打印技术制作个性化钛合金肋骨假体的力学性能和应力分布,探讨个性化肋骨假体在修复胸壁多发肋骨缺损时应用的可行性。方法:通过胸部CT三维重建数据构建骨性胸廓模型,模拟截骨修复过程,设计出肋骨假体的三维数据并进行三维有限元分析;采用钛合金粉末打印出与缺损肋骨完全匹配的假体,进行强度测试;最后进行手术植入完成胸壁缺损的修复。结果:假体模型的三维有限元分析显示,肋骨假体等效应力分布均匀。3D打印钛合金肋骨假体的屈服强度为(950±14)MPa,极限强度为(1 005±26)MPa。假体植入重建术精确复原了胸廓的几何形态及解剖外形,随访期间植入物与周围骨性结构固定牢靠,与周围组织相容性良好,无排异反应发生。结论:通过计算机辅助设计和3D打印技术能够制作出高精度个性化钛合金肋骨假体,材料性能满足临床植入物的标准,个性化肋骨假体对胸壁重建塑形效果好,手术操作简便,此方法是肋骨缺损修复的可靠技术保证。Objective：We studied the mechanical properties and stress distribution of custom design and printed rib prosthesis in reconstructing large rib defects of chest wall following en - bloc surgery, demonstrating its feasibility. Methods：3D model of the bony defect was generated after the acquisition of helical CT data. A customized implant was designed using computer aided design （CAD） and mirror technology and later fabricated using titanium alloy powder. The end result product were then fixed onto patient during surgery. Results： The yield strength of the titanium - alloy implants were （950 ± 14） MPa, and the ultimate tensile strength were （ 1 005 ± 26） MPa. Three dimensional finite element analysis results showed an evenly stress distribution of the implant. The construction quality and contour of the repaired chest wall was satisfactory. No rejection occurred during the 6 months follow - up. Conclusion ： Chest reconstruction with customized titanium alloy rib prosthesis is a reliable technique for the repair of the bony defect.

关 键 词：3D打印 钛合金假体 胸壁缺损 修复 

分 类 号：R730.5[医药卫生—肿瘤]