3D打印数字化外科在面中份骨折整复中的应用研究  

Application of 3D printing digital surgery in the treatment of Mid-facial fracture

作　　者：胡旻 曹璐璐 李忠 马猛 艾克拜尔·塔吉 HU Min;CAO Lu-lu;LI Zhong;MA Meng;Akber(Urumqi Myour dental clinic,Xinjiang Uygur Autonomous Region,830000,China)

机构地区：[1]新疆乌鲁木齐美奥口腔医院,新疆乌鲁木齐830000

出　　处：《中国医疗美容》2020年第8期41-45,共5页China Medical Cosmetology

基　　金：自治区卫生计生委青年医学科技人才专项科研项目,项目编号:WJWY-201924。

摘　　要：目的将3D打印技术应用在面中份粉碎性骨折整复手术中,探寻数字化外科、精准医学在手术过程中的优势。方法选取我院2017年4月-2020年4月口腔颌面外科收治的面中份粉碎性骨折病例17例。术前完成数据采集,根据DICOM软件数据进行患者头面部骨性解剖的3D虚拟重建,同期完成虚拟复位,打印出模型后提前预弯钛板,在正式进行手术复位时,以它作为手术复位的标准,指导手术,术中验证匹配程度,测量术前、术后眼球突度、睑裂对称指数、内眦鼻梁矢状高度对称指数、VSA患者自评等指标。结果在3D打印技术支持下,所有的手术病例均顺利完成,平均手术时间较传统手术明显缩短,与健侧数据进行对比,眼球突度、睑裂对称指数、内眦鼻梁矢状高度对称指数、VSA患者自评等检测数据均得到很好地改善,P<0.05。患者术后面部外形改善明显,复位效果满意。其中4例患者术后感染,抗炎后症状明显改善。1例患者术后复视无改善,半年后症状消失。3例脑脊液漏,术后1个月症状消失。结论在3D打印技术支持下,通过术前采集测量、虚拟复位、术前预弯等技术,极大地提高了面中份粉碎性骨折术中复位的精准性、压缩了手术时间,故很大程度上减少了并发症的发生。值得临床开展应用。Objective explore the advantages of digital surgery and precision medicine in the reconstruction of Mid-facial fracture by using 3D printing technology.Methods A total of 17 cases of comminuted Mid-facial fractures admitted to the oral and maxillofacial surgery department of our hospital from 2017 to 2019 were selected.Preoperative complete data collection,data based on DICOM software for patients with facial osseous anatomy of 3 d virtual reconstruction,at the same time to complete the virtual reset,print out the model of bending titanium plate in advance,after the surgery in the formal reset,with it as a standard of surgical repositioning,guide operation,measure the degree of preoperative and postoperative eyeball,palpebral fissure symmetry index,angular nose sagittal height symmetry index,VSA indexes of patients'self-reported.Results With the support of 3D printing technology,all cases were successfully completed,with an average operation time of about 2.5-3.5 hours.Compared with the data of the healthy side,the measurement data of the degree of protuberance of the eyeball,the symmetry index of the eyelid fissure,the sagittal height symmetry index of the medial canthus bridge,and the self-rating of the VSA patients were all well improved,P<0.05.The facial appearance of the patient improved significantly and the reduction effect was satisfactory.Among them,4 ptients were infected after operation,and their symptoms were significantly improved after anti-inflammatory treatment.There was no improvement in diplopia in 1 patient,and the symptoms disappeared after 6 months.Cerebrospinal fluid leakage occurred in 3 patients,and the symptoms disappeared one month after surgery.Conclusion With the support of 3D printing technology,through preoperative collection and measurement,virtual reduction,preoperative prebending,intraoperative guidance and other technologies,the accuracy of reduction in the operation of nasoethmoid composite fracture was greatly improved,and the operation time was compressed,so the occurrence of

关 键 词：3D打印 面中份骨折 虚拟复位 数字化外科 精准医学 

分 类 号：R782.4[医药卫生—口腔医学]