3D打印导板在单侧颧上颌骨粉碎性骨折中的应用  

Application of 3D printing guide plate in unilateral zygomatic maxilla comminuted fracture

作　　者：库都斯·克依木[1] 徐前[1] 卡米力江·买买提明[1] 许辉[1] Kudusi Keyimu;XU Qian;Kamilijiang Maimaitiming;XU Hui(Oral and Maxillofacial Surgery Department,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,830000,China)

机构地区：[1]新疆维吾尔自治区人民医院口腔颌面外科,乌鲁木齐830000

出　　处：《新疆医学》2025年第3期285-289,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区科技支疆项目(项目编号:2020E0284);新疆维吾尔自治区人民医院院内项目(项目编号:20210233)。

摘　　要：目的分析3D打印导板与传统手术方法在复位单侧颧上颌骨粉碎性骨折中的应用效果。方法选取2020年1月至2023年3月在新疆维吾尔自治区人民医院口腔颌面外科实施单侧颧上颌骨骨折复位手术患者48例,根据患者进行的术式分为2组,每组24例。其中3D导板组给予术前3D重建及导板设计,3D打印导板辅助颧上颌骨骨折复位固定。常规组行单侧粉碎性颧上颌骨骨折复位固定的传统手术方法。两组患者术后1个月进行随访观察,评估两组患者面形恢复满意评分(Ⅰ-Ⅲ级),健侧与术前患侧3D重建CT参数变化、手术时间,术后相关并发症(面容畸形、泪囊炎、关系紊乱、复视、眶下区麻木等)情况。结果两组健侧与术前患侧3D重建CT参数(L1、L2、L3、颧突角、颧弓角)指标比较,无统计学意义(P>0.05)。术后,3D导板组的3D重建CT参数△L1、△L2、△L3、△α、△β指标均小于常规组(P<0.05)。3D导板组的面形恢复满意评分Ⅰ级为9例,占比为37.50%,明显高于常规组的3例(12.50%)(P<0.05);Ⅲ级为1例,占比为4.17%,明显低于常规组的8例(33.33%)(P<0.05)。3D导板组的手术时间(185.45±18.38)min,短于常规组(201.55±23.64)min(P<0.05)。3D导板组与常规组患者的泪囊炎、伤口感染、张口受限、眶下区麻木的相关并发症发生率(12.50%vs 20.83%)比较,无统计学意义(P>0.05)。结论3D打印导板在复位单侧颧上颌骨粉碎性骨折术后的骨折复位精确度高,双侧面部对称形态恢复良好,并发症率低,满意度高。Objective To analyze the effectiveness of 3D printed guides versus traditional surgical methods in resetting unilateral zygomatic maxillary comminuted fractures.Methods Forty-eight patients who underwent unilateral zygomatic maxillary fracture repositioning surgery in the Department of Oral and Maxillofacial Surgery of the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to March 2023 were selected,and the patients were divided into 2 groups of 24 cases each according to the procedure performed.In the 3D guide group,preoperative 3D reconstruction and guide design were given,and 3D printed guides were used to assist in the repositioning and fixation of the zygomatic maxillary fracture.In the conventional group,the conventional surgical method of unilateral comminuted zygomatic maxillary fracture repositioning and fixation was performed.Patients in both groups were followed up and observed 1 month after surgery to assess the satisfactory facial shape recovery score(grade Ⅰ-Ⅲ),changes in 3D reconstructed CT parameters between the healthy side and the affected side before surgery,operation time,and postoperative related complications(facial deformity,lacrimal sacculitis,relationship disorder,diplopia,and numbness in the infraorbital region).Results The 3D reconstruction CT parameters(L1,L2,L3,zygomatic prominence angle,zygomatic arch angle)indexes were not statistically significant when comparing the healthy side with the affected side before surgery in both groups(P>0.05).After surgery,the 3D reconstruction CT parameters ΔL1,ΔL2,ΔL3,Δα and Δβ indexes of the 3D guide plate group were smaller than those of the conventional group(P<0.05).9 cases(37.50%)in the 3D guide plate group had a satisfactory facial shape recovery score of grade Ⅰ,which was significantly higher than that of the conventional group(3 cases(12.50%))(P<0.05);1 case(4.17%)in grade Ⅲ,which was significantly lower than that of the conventional group(8 cases(33%)).The operative time in the 3D-printed guide group was

关 键 词：单侧颧上颌骨粉碎性骨折 3D打印 导板 满意度 对称性 并发症 

分 类 号：R782.4[医药卫生—口腔医学]