3D打印技术在髋臼发育不良髋关节置换中的初步应用

发布时间：2018-02-21 17:26

本文关键词： D打印手术规划髋臼发育不良全髋关节置换术医患沟通　出处：《中国矫形外科杂志》2016年17期 　论文类型：期刊论文

【摘要】：[目的]探讨3D打印技术在髋臼发育不良髋关节置换术前规划中的应用效果及在医患沟通中的作用。[方法]2012年1月~2015年1月对收治的10例拟行全髋关节置换术的髋臼发育不良患者的髋关节进行3D打印。采用64层螺旋CT对患者进行平扫,扫描结束后进行薄层重建。提取患者CT检查结果的DICOM格式文件,使用三维医学影像数据处理平台进行后处理,然后进行3D打印获得患者髋关节的3D打印模型。设计分别针对医学专业人员和患者的开放性调查问卷,作为评价工具验证模型的逼真性和有用性。请5名关节外科专家使用针对医学专业人员的问卷对模型的逼真性及有用性进行评分,2名术者于术后对3D打印模型规划的手术效果进行反馈评分,评估术前计划拟定的置入假体型号与关节置换中实际使用型号的差异。使用患者个性化髋关节模型与患者或指定家属进行术前谈话,使用针对患者的问卷对谈话效果评分。[结果]成功打印出10例患者的髋关节3D模型,髋关节的解剖形态显示良好。10例手术均顺利完成。5名专家和2名术者对3D打印模型的逼真性和有用性的总体评分为(8.1±0.7)分。2例患者实际假体的型号与术前计划拟定的相差一个尺寸。患者对3D打印模型用于手术交流的满意度评分为(9.1±0.7)分。[结论]3D打印模型能够很好地显示髋关节的解剖形态,并可以有效帮助医生进行手术规划,还可以用作与患者交流的工具,使医患沟通变得顺畅。
[Abstract]:[objective] to investigate the effect of 3D printing in the planning of acetabular dysplasia before hip arthroplasty and its role in doctor-patient communication. [methods] from January 2012 to January 2015, 10 patients with total hip arthroplasty were treated with total hip arthroplasty. The hip joint of acetabular dysplasia was printed in 3D. 64-slice spiral CT was used to scan the hip joint. After scanning, thin-layer reconstruction was carried out. The DICOM format files of patients'CT examination results were extracted, and the data processing platform of three-dimensional medical image was used for post-processing. Then 3D printing was carried out to obtain the 3D print model of the hip joint of the patient. An open questionnaire was designed for medical professionals and patients. Verify the verifiability and usefulness of the model as an evaluation tool. Ask 5 arthrosurgery experts to rate the authenticity and usefulness of the model using a questionnaire for medical professionals and 2 operators to print the model rules in 3D after surgery. The operative effect of the stroke was evaluated with feedback, Evaluate the difference between the pre-planned implant type and the actual type used in the arthroplasty. Use the patient's personalized hip joint model to talk to the patient or a designated family member before surgery. A questionnaire for patients was used to evaluate the effect of conversation. [results] A 3D model of hip joint was successfully printed out in 10 patients. The anatomy of hip joint showed good. All 10 cases of operation were completed successfully. The overall score of lifelike and useful 3D printing model was 8.1 卤0.7 for 5 experts and 2 operators. The actual prosthesis type and preoperative plan were drawn up in 2 patients. The patient's satisfaction with 3D printing model for surgical communication was 9.1 卤0.7. [conclusion] 3D print model can show the anatomical shape of hip joint well. It can also be used as a tool to communicate with patients and make communication between doctors and patients smooth.
【作者单位】：贵州医科大学附属医院骨科;贵州省再生医学重点实验室;贵州省紫云苗族布依族自治县人民医院骨科;贵州医科大学附属口腔医院修复科;
【基金】：国家自然科学基金资助项目(编号:81360232) 贵阳市科技局资助项目(编号:GY20141001)
【分类号】：R687.4

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