3D打印腰椎穿刺模型在骨科临床教学中的应用  

Application of 3D printed lumbar puncture models in orthopedic clinical teaching

作　　者：袁德超 吴超[1,2] 邓佳燕[2] 林旭[1] 谭伦[1] 王翔宇 王伟[3] 罗敏[3] YUAN Dechao;WU Chao;DENG Jiayan;LIN Xu;TAN Lun;WANG Xiangyu;WANG Wei;LUO Min(Section I,Department of Orthopaedics,the Fourth People's Hospital of Zigong,Zigong,Sichuan 643000,P. R. China;Digital Medical Center,the Fourth People's Hospital of Zigong,Zigong,Sichuan 643000,P. R. China;Department of Radiology,the Fourth People's Hospital of Zigong,Zigong,Sichuan 643000,P. R. China)

机构地区：[1]自贡市第四人民医院骨一科,四川自贡643000 [2]自贡市第四人民医院数字医学中心,四川自贡643000 [3]自贡市第四人民医院放射科,四川自贡643000

出　　处：《华西医学》2019年第9期999-1004,共6页West China Medical Journal

基　　金：四川省重点科技计划项目(2016JY0108);自贡市重点科技计划创新苗子项目(2018CXMZ05);自贡市重点科技计划项目(2017RK02)

摘　　要：目的探讨基于3D打印技术构建腰椎穿刺模型,用于培训低年资骨科医师寻找椎弓根螺钉最佳进钉点的可行性。方法于2018年1月-2019年6月期间,基于Mimics软件设计带有最佳安全通道和备选通道的腰椎三维模型,同比例打印出腰椎实体模型,用橡皮泥、布料包裹构建成3D打印腰椎穿刺模型。43名骨科住院医师规范化培训学员在该模型上模拟手术寻找腰椎椎弓根螺钉进钉点,每天操作1次,连续操作10 d,比较学员不同时间的操作得分、操作时间的差异。结果所有学员顺利完成手术培训操作,学员10次操作的手术得分依次为(13.05±2.45)、(14.02±3.96)、(17.58±3.46)、(21.02±2.04)、(23.40±4.08)、(25.14±3.72)、(27.26±6.09)、(33.37±4.23)、(35.00±4.15)、(38.49±1.70)分,差异有统计学意义(F=340.604,P<0.001),学员10次操作的手术时间依次(22.51±4.28)、(19.93±4.28)、(18.05±2.89)、(17.05±1.76)、(16.98±1.97)、(15.47±1.74)、(13.51±1.42)、(12.60±2.17)、(12.44±1.71)、(11.91±1.87)min,差异有统计学意义(F=102.359,P<0.001)。结论基于3D打印技术构建的腰椎穿刺模型,可行性强,可重复操作,是良好的手术培训模型。Objective To explore the feasibility of lumbar puncture models based on 3D printing technology for training junior orthopaedic surgeons to find the optimal pedicle screw insertion points. Methods Mimics software was used to design 3D models of lumbar spine with the optimal channels and alternative channels. Then, the printed lumbar spine models, plasticine, and cloth were used to build lumbar puncture models. From January 2018 to June 2019, 43 orthopedic trainees performed simulated operations to search for the insertion points of pedicle screws base on the models. The operations were performed once a day for 10 consecutive days, and the differences in operation scores and operation durations of the trainees among the 10 days were compared. Results All the trainees completed the surgical training operations successfully, and there were significant differences in the operation scores (13.05±2.45, 14.02±3.96, 17.58±3.46, 21.02±2.04, 23.40±4.08, 25.14±3.72, 27.26±6.09, 33.37±4.23, 35.00±4.15, 38.49±1.70;F=340.604, P<0.001) and operation durations [(22.51±4.28),(19.93±4.28),(18.05±2.89),(17.05±1.76),(16.98±1.97),(15.47±1.74),(13.51±1.42),(12.60±2.17),(12.44±1.71),(11.91±1.87) minutes;F=102.359, P<0.001] among the 10 days. Conclusion The 3D models of lumbar puncture are feasible and repeatable, which can contribute to surgical training.

关 键 词：3D打印技术 手术模型 临床教学 椎弓根螺钉 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]