个体化导板联合术中导航辅助陈旧性面中部骨折的精准整复治疗  

EFFECT OF INDIVIDUALIZED GUIDE PLATE COMBINED WITH INTRAOPERATIVE NAVIGATION IN ASSISTING THE PRECISION REDUCTION OF OLD MIDFACIAL FRACTURE

作　　者：杨成帅 回文宇 徐晓峰[1] 吴锦阳[1] 张勇[1] 张诗雷[1] YANG Chengshuai;HUI Wenyu;XU Xiaofeng;WU Jinyang;ZHANG Yong;ZHANG Shilei(Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颅颌面科,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《精准医学杂志》2020年第5期420-423,427,共5页Journal of Precision Medicine

基　　金：国家自然科学基金资助项目(81671035,8170103-4);上海市卫生和计划生育委员会卫生行业临床研究专项(2018400-75);上海交通大学医学院医学教育研究项目(ZD170704);上海交通大学医学院转化医学协同创新中心项目(TM201717);上海交通大学医学院附属第九人民医院交叉学科基金项目(201818040);上海交通大学医学院附属第九人民医院科技创新基金(CK2018003);上海交通大学医学院附属第九人民医院临床研究助推计划(JYL2019-20);上海交通大学医学院附属第九人民医院临床研究型MDT项目(201701013,201906)。

摘　　要：目的评价个体化导板联合术中导航辅助陈旧性面中部骨折整复治疗的有效性及精确性。方法将2017年1月—2019年12月于我院住院的陈旧性面中部骨折患者58例纳入本研究。术前患者均行三维全颅脑CT扫描,应用Proplan 3.0软件进行数据分割并制定个性化的虚拟手术方案,术中通过个体化导板联合Accu-Navi手术导航系统引导手术操作。所有患者术后均进行颅脑三维CT扫描,并通过Geomagic Studio软件与术前设计拟合进行光谱色差对比,从而评价治疗效果。结果所有患者术后功能与外形均得到良好恢复,且无严重手术并发症,对术后效果均满意。通过术后CT与术前虚拟设计拟合评估术后骨折复位精度,平均误差为(0.65±1.35)mm。结论对于陈旧性面中部骨折的整复治疗,个体化导板与术中导航的联合应用,可以使虚拟手术方案更加精准地应用到实际手术操作中,为外科医生提供更精准高效的手术引导,从而提高手术精度及治疗效果。Objective To investigate the effect and accuracy of individualized guide plate combined with intraoperative navigation in assisting the reduction of old midfacial fracture.Methods A total of 58 patients with old midfacial fracture who were hospitalized in our hospital from January 2017 to December 2019 were enrolled.All patients underwent three-dimensional whole-brain CT scan,and Proplan 3.0 software was used to perform image segmentation and develop individualized virtual surgery plan.The surgery was guided by the individualized guide plate combined with Accu-Navi surgical navigation system.Three-dimensional whole-brain CT scan was performed for all patients after surgery,and the images obtained were imported into Geomagic Studio software to fit with the preoperative design and evaluate the treatment outcome.Results All patients achieved satisfactory recovery of function and appearance without serious complications and were satisfied with the surgical outcome.Postoperative CT images were fitted with the preoperative virtual design to evaluate the accuracy of reduction of fracture,and the mean error was 0.65±1.35 mm.Conclusion For the reduction of old midfacial facture,individualized guide plate combined with intraoperative navigation can provide more accurate application of virtual surgery plan in actual surgical operation and more accurate and efficient surgical guidance for surgeons,so as to improve surgical accuracy and treatment outcome.

关 键 词：计算机模拟 手术导板 外科手术 计算机辅助 修复外科手术 面部损伤 精准医学 

分 类 号：R782.2[医药卫生—口腔医学] R683[医药卫生—临床医学]