虚拟重建及3D打印复合导板在经口气管插管复杂颌面部骨折复位中的应用  

Application of 3D Printed Composite Guide Plate in Assisting the Reduction of Complex Maxillofacial Fractures under Oral Intubation General Anesthesia

作　　者：顾徐嘉 孟箭 李志萍[2,3] GU Xujia;MENG Jian;LI Zhiping(Stomatology School of Xuzhou Medical University,Xuzhou 221000,China;Department of Stomatology,Xuzhou Centra Hospital,Xuzhou 221000,China;Xuzhou Clinical College,Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学口腔医学院,江苏徐州221000 [2]徐州市中心医院口腔科,江苏徐州221000 [3]徐州医科大学徐州临床医学院,江苏徐州221000

出　　处：《口腔医学研究》2023年第9期785-791,共7页Journal of Oral Science Research

基　　金：江苏省研究生科研与实践创新计划项目(编号:SJCX22_1290)。

摘　　要：目的:探讨个性化设计3D打印复合骨折复位导板在经口插管全身麻醉下辅助颌面部复杂骨折复位手术的临床效果。方法:选择21例2021年10月~2023年6月就诊于徐州市中心医院颌面部复杂骨折的患者,随机分为3D打印导板组(实验组)10例,传统手法复位组(对照组)11例进行手术,术后进行色谱图评价、临床评价及选取颌骨解剖标志点进行对称性评价。结果:实验组较对照组节省手术时间平均约40 min,术后3月复查均未发生相关并发症,对照组1例患者仍存在咬合错乱。实验组色谱图分析显示与术前虚拟手术模型的平均偏差度和最大偏差度的均值分别为(0.13±0.97)mm和(2.72±0.99)mm,显著小于对照组的(0.32±0.23)mm及(3.91±1.02)mm(P<0.05)。面下1/3对称性分析表明实验组要显著优于对照组(P<0.05),使用导板辅助手术能更精确达到术前预期(P<0.05)。结论:采用个性化设计3D打印复合导板能辅助手术医生在经口插管全身麻醉条件下快速重建咬合,缩短手术时间,进行骨折段精准复位。Objective:To explore the clinical effect of personalized designed 3D printed composite guide plates in assisting reduction of complex maxillofacial fracture surgery under oral intubation general anesthesia.Methods:Twenty-one patients with complex maxillofacial fractures who were treated at Xuzhou Central Hospital from October 2021 to June 2023 were randomly divided into 3D printed guide plate group(experimental group,10 cases)and traditional manual reduction group(control group,11 cases).After surgery,chromatogram evaluation,clinical evaluation,and symmetry evaluation of jaw anatomical landmarks were performed.Results:The experimental group saved an average of about 40 minutes in contrast to the control group,and no related complications occurred after 3 months of follow-up.One patient in the control group still had malocclusion.The chromatogram analysis of the experimental group showed that the mean and maximum deviations from the preoperative virtual surgery model were(0.13±0.97)mm and(2.72±0.99)mm,which were significantly lower than those of control group(0.32±0.23)mm and(3.91±1.02)mm,(P<0.05).The symmetry analysis showed that the experimental group was significantly better than the control group(P<0.05),and the use of guide plate assisted surgery achieved more accurate preoperative expectations(P<0.05).Conclusion:The use of personalized 3D printed composite guide plates can assist surgeons in quickly finding occlusions under oral intubation general anesthesia,shorten surgical time,and achieve precise reduction of fracture segments.

关 键 词：3D打印 骨折复位导板 气管插管 颌面部复杂骨折 数字化 

分 类 号：R782.4[医药卫生—口腔医学]