三维打印个体化导板定位下微创穿刺HCH的疗效探讨  

Effect of minimally invasive puncture of HCH by three dimensional printing ividualized guide-plate

作　　者：丁向前[1] 杨璐瑶[1] 李珍珠[1] 王清波[1] 陈正[1] 孙其凯 耿鑫[1] 李泽福[1] 

机构地区：[1]滨州医学院附属医院神经外科,滨州256603

出　　处：《中华神经创伤外科电子杂志》2017年第5期260-263,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：国家自然科学基金(81171119);滨州医学院校级课题(BY2014KJ52);山东省滨州市科技发展计划项目(2015ZC0302)

摘　　要：目的探讨基于计算机辅助设计(CAD)的三维打印(3DP)个体化导板定位下微创穿刺引流术对高血压脑出血(HCH)患者的治疗效果。方法选取自2015年9月至2017年5月滨州医学院附属医院神经外科诊治的108例HCH患者为研究对象,随机分为2组,穿刺组48例患者接受基于CAD的3DP个体化导板定位下微创穿刺引流术治疗,对照组60例患者接受小骨窗显微开颅术治疗,对比2组患者术后并发症发生率及临床疗效。穿刺组患者以头颅高分辨CT资料为基础,通过计算机辅助获得三维立体图像并设计1个包含穿刺通道的最优个体化导板,采用3DP技术进行打印得到立体实物模型,术前凭借实物模型直观形象的同患者及家属进行病情介绍及手术方案的沟通,并模拟具体的微创穿刺过程。术中个体化导板定位指导穿刺方向及深度。结果穿刺组患者术后并发症发生率和临床疗效与对照组对比,差异无统计学意义(P>0.05)。结论小骨窗显微开颅术治疗HCH已基本得到学者的公认,基于CAD的3DP个体化导板定位下微创穿刺引流术与小骨窗显微开颅术治疗HCH对比,治疗效果无差异,其安全可靠而值得推广应用,尤其在未达到显微治疗条件的基层医院。Objective This paper investigates the efficacy of by computer aided design（CAD）-based three dimensional printing（3DP） individualized guideboard assisted minimally invasive perforation on patients with hypertensive cerebral hemorrhage（HCH）.Methods A total of 108 patients with HCH were enrolled in our department from September 2015 to May 2017,they were randomly divided into two groups,the 48 patients in the invasive group received CAD-based 3 DP perforation surgery,the microscopic group of 60 patients received small bone window minimally invasive craniotomy treatment,compared the two groups of patients with postoperative complications and clinical efficacy.On the basis of high-resolution CT data of the invasive group,the three-dimensional images were obtained by computer-aided design and an optimal individualized guideboard was designed,after 3DP technique was used to print,preoperative communicate with the patient and their families the disease and surgical programs by physical model intuitively,and simulate the specific minimally invasive puncture process.Intraoperative individual guides guide the direction and depth of puncture.Results The incidence of postoperative complications and clinical efficacy in the invasive group were compared with the microscopic group,the difference was not statistically significant（P〈0.05）.Conclusion Small bone window minimally invasive craniotomy treatment of HCH has been largely accepted by scholars,the invasive group were compared with the microscopic group,treatment effect is no remarkable,which is safe and reliable and worthy of promotion and application,especially the basic-level hospitals that do not meet the conditions of microsurgery treatment.

关 键 词：数字医学 三维打印技术 个体化导板 微创穿刺引流术 高血压脑出血 

分 类 号：R651.12[医药卫生—外科学]