3D打印技术用于精准修复眼眶爆裂性骨折的临床研究  

APPLICATION OF 3D PRINTING TECHNIQUE IN ACCURATE SURGICAL REPAIR OF ORBITAL BLOWOUT FRACTURE

作　　者：唐春 杨先[1] 高岩[1] 张杰[1] 许丽丽 张雨晴 TANG Chun;YANG Xian;GAO Yan;ZHANG Jie;XU Lili;ZHANG Yuqing(Department of Ophthalmology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院眼科

出　　处：《精准医学杂志》2019年第4期326-329,333,共5页Journal of Precision Medicine

摘　　要：目的探讨个体化3D打印眼眶模型辅助预成型Medpor人造骨板精准修复眼眶爆裂性骨折的临床效果及安全性。方法选择2016年8月—2017年8月来我院眼科就诊的单眼眼眶爆裂性骨折患者21例。将患者以是否利用3D打印技术辅助手术分为试验组10例和对照组11例,试验组术中采用个体化3D打印眼眶模型辅助预成型Medpor人造骨板修复眼眶爆裂性骨折,对照组术中采用常规Medpor人造骨板修复眼眶爆裂性骨折。两组术后进行眼眶CT检查,观察Medpor人造骨板在眼眶骨折缺损位置的贴附情况;随访3~6个月,比较两组眼眶容积差、眼球突度差及复视治愈率;比较两组手术时间及术中人造骨板一次性植入率;随访记录两组并发症发生情况。结果试验组预成型骨板与骨折各缘贴合完整,基本达到了眼眶的解剖复位,效果明显优于对照组。两组术前眼眶容积差、眼球突度差比较,差异无显著性(P>0.05);两组术后眼眶容积差、眼球突度差比较,差异有显著性(t=2.62、2.69,P<0.05)。两组术后2周、3个月复视治愈率比较,差异无显著性(P>0.05)。试验组手术时间较对照组明显减少(t=2.25,P<0.05)。试验组人造骨板一次性植入率高于对照组(χ2=5.74,P<0.05)。两组随访过程中均未发生严重并发症。结论应用个体化3D打印眼眶模型辅助预成型Medpor人造骨板适用于眼眶爆裂性骨折的修复,并且可以更加精确地恢复眼眶解剖形态和眼眶容积,手术时间明显缩短,术后眼球内陷情况改善良好,治疗安全有效。[Objective]To investigate the clinical effect and safety of an orbital model made by the individualized 3D prin-ting technique combined with a pre-shaped Medpor artificial bone plate in the accurate repair of orbital blowout fracture.[Methods A total of 21 patients with orbital blowout fracture in one eye who visited Department of Ophthalmology in our hospital from August 2016 to August 2017 were enrolled.According to whether 3D printing technique was applied,these patients were divided into experimental group with 10 patients and control group with 11 patients.The patients in the experimental group used an orbital model made by the individualized 3D printing technique combined with a pre-shaped Medpor artificial bone plate in the repair of orbital blowout fracture,and those in the control group used a conventional Medpor artificial bone plate.Orbital CT was performed after surgery to observe the attachment of the Medpor artificial bone plate in the position of orbital fracture defect.The patients were followed up for 3-6 months,and the two groups were compared in terms of orbital volume,degree of eyeball protrusion,cure rate of diplopia,time of operation,and one-time success rate of artificial bone plate implantation.The incidence rates of complications were recorded during follow-up.[Results]In the experimental group,the pre-shaped bone plate was perfectly attached to the facture and anatomical reduction of the orbital cavity was achieved,and the experimental group had a significantly better cli-nical outcome than the control group.There were no significant differences between the two groups in orbital volume and degree of eyeball protrusion before treatment(P>0.05),and after treatment,there were significant differences in orbital volume and degree of eyeball protrusion between the two groups(t=2.62,2.69,P<0.05).There was no significant difference between the two groups in the cure rate of diplopia at 2 weeks and 3 months after surgery(P>0.05).Compared with the control group,the experimental group had a signifi

关 键 词：眶骨折 打印 三维 眼眶植入物 眼眶容积 眼球突度 Medpor人造骨板 修复外科手术 精准医学 

分 类 号：R777.5[医药卫生—眼科]