虚拟手术结合3D打印导板辅助游离腓骨瓣修复重建下颌骨缺损的临床研究  

Clinical study of virtual surgery combined with 3D-printed plates assisted free fibula flap in the repair and reconstruction of mandibular defects

作　　者：李朔 厚富坤 苏浩然 范戌辉[1] 董剑峰 刘耀强[1] 陈彪[1] LI Shuo;HOU Fukun;SU Haoran;FAN Ronghui;DONG Jianfeng;LIU Yaoqiang;CHEN Biao(Oral And Maxillofacial Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000)

机构地区：[1]河北医科大学第二医院口腔颌面外科,石家庄050000

出　　处：《现代口腔医学杂志》2024年第6期425-431,共7页Journal of Modern Stomatology

基　　金：河北省财政厅政府资助临床医学优秀人才培养项目(303-2022-27-30)。

摘　　要：目的评价虚拟手术结合3D打印导板辅助腓骨瓣修复重建下颌骨缺损的临床效果。方法选取因颌面部肿瘤行下颌骨切除及同期腓骨瓣修复的患者16例。8例采用上述技术辅助;8例采用传统术式。对比两组手术时间、腓骨瓣缺血及塑形时间、出血量、术后住院天数、咬合关系、面部外形视觉模拟评分(VAS);测量两组术前术后双侧髁突间距离、下颌角间距离、下颌升支、下颌骨体长度,组间对比差异。结果采用上述技术辅助组在手术、腓骨瓣缺血及塑形时间、出血量、术后住院天数上均小于传统组,面部外形视觉模拟评分(VAS)高于传统组、术前术后的下颌骨标志点距离差异均小于传统组,差异具有统计学意义(P<0.05);术后咬合关系无统计学差异(P>0.05)。结论对比传统手术,数字化技术使得手术及重塑时间缩短,出血量、术后住院天数减少,下颌骨缺损修复重建的美观性和准确性得到加强。Objective To evaluate the clinical effect of virtual surgery combined with 3D printing guide plate assisted fibula flap repair and reconstruction of mandibular defects.Methods Sixteen patients with maxillofacial tumors who underwent mandibular resection and fibula flap repair at the same time were selected.8 cases were assisted by the above techniques;8 cases were treated with traditional operation.The operation time,fibula flap ischemia and shaping time,bleeding volume,postoperative hospital stay,occlusion relationship and visual analogue scale(VAS)of facial appearance were compared between the two groups.The distance between bilateral condyle and mandibular angle,the length of mandibular ramus and mandibular body were measured before and after operation,and the differences between the two groups were compared.Results The operation,fibula flap ischemia and shaping time,bleeding volume and postoperative hospital stay in the above-mentioned technique-assisted group were less than those in the traditional group.The visual analogue scale(VAS)of facial appearance was higher than that in the traditional group,and the distance of mandibular landmarks before and after operation was less than that in the traditional group.The difference was statistically significant(P<0.05).Conclusion Compared with traditional surgery,digital technology shortens the operation and remodeling time,reduces the amount of bleeding and postoperative hospital stay,and enhances the aesthetics and accuracy of mandibular defect repair and reconstruction.

关 键 词：虚拟手术 3D打印导板 下颌骨重建 游离腓骨瓣 

分 类 号：R782.4[医药卫生—口腔医学]