3D打印手指静态进展性牵伸支具的设计及临床应用  

The design and clinical application of 3D printed finger static progressive stretch splint

作　　者：樊佳俊[1] 许佳 李馨 韩冬[1] FAN Jiajun;XU Jia;LI Xin;HAN Dong(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,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整复外科,上海市200011

出　　处：《组织工程与重建外科》2021年第4期308-313,共6页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：上海交通大学医学院附属第九人民医院“交叉”基金(JYJC201805)。

摘　　要：目的研究和设计一种新型3D打印的手指静态进展性牵伸(Static progressive stretch,SPS)支具,并观察其在手指掌侧瘢痕挛缩松解植皮术后患者家庭康复中的应用效果。方法2020年9月至2021年5月收治的手指掌侧瘢痕挛缩松解植皮术后患者中选取符合入组标准的患者,采用区组随机化方法进行分组,两组分别使用3D打印手指SPS支具(试验组)和常规静态支具(对照组)进行家庭康复训练。3D打印手指SPS支具通过采用激光扫描技术、计算机辅助设计以及3D打印技术实现快速成型。治疗前、治疗后1个月及治疗后2个月进行随访,分别评价两组患者的近侧指间关节的主动关节活动度(Active range of motion,AROM)、被动关节活动度(Passive rang of motion,PROM)、疼痛模拟视觉评分(Visual analogue scale,VAS)、DASH上肢功能损伤评定表、Morisky服药依从性量表(Morisky medication adherence scale,MMAS-8)和魁北克辅具使用者满意度评估量表(Quebec user evaluation of satisfaction with assistive technology 2.0,QUEST 2.0)等指标,并进行成本-效果分析。结果本研究共纳入患者22例,试验组和对照组各11例。两组AROM、PROM、VAS以及DASH评分在治疗后均有改善(P<0.05),试验组的改善更为明显(P<0.05),满意度和依从性也更高(P<0.05),更具成本-效果意义(P<0.05)。结论经过数字化设计的3D打印手指SPS支具具有一定可行性以及进一步研究和临床应用的价值,也为同类型支具的设计提供了一定的参考。Objective To design and study a new kind of 3D printed finger static progressive stretch splint,and observe its clinical effects in family rehabilitation of patients with volar scar contracture after skin grafting and relaxation.Methods Patients who met the inclusion criteria after the release and skin grafting of volar finger scar contracture admitted from September 2020 to May 2021 were selected.Using block randomization design,the patients were divided into experimental group and control group.Experimental group used 3D printed splint in family rehabilitation,and the control group used conventional static splint instead.The 3D printed finger progressive stretch splint was designed and manufactured by laser scanning technology,computer-aided design(CAD)and 3D printing technology.The indexes were evaluated before treatment,1 month and 2 months after treatment.AROM,PROM,VAS,DASH,MMAS-8 and QUEST 2.0 were compared in the two groups.And the cost-effectiveness analysis was carried out as well.Results Totally 22 patients(11 patients in each group)were included in the study.After treatment,significant increment of the AROM,PROM,VAS and DASH were observed in both two groups(P<0.05).The improvement in the experimental group was more significant than that of control group(P<0.05).The satisfaction and compliance of the experimental group were higher(P<0.05).And there was more cost effective in the experimental group(P<0.05).Conclusion The 3D-printed finger static progressive stretch splint with digital design has certain feasibility,further research and clinical application value,and also can provide certain reference for the design of the same type of splint.

关 键 词：3D打印 手指 静态进展性支具 关节挛缩 

分 类 号：R318.08[医药卫生—生物医学工程]