3D打印技术在足踝骨折诊治与教学的应用研究

发布时间：2018-05-01 17:22

本文选题：3D打印技术 + 足踝骨折　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:利用3D打印技术重建患者数据,通过3D打印机,获得接近1:1病变部位的实物模型,将3D重建软件及模型引入足踝骨折病例诊治与教学,探讨其应用价值。方法:病例分别选自我院40例足踝骨折患者的术前影像学资料,pilon骨折10例、踝周骨折18例、跟骨骨折12例,使用Mimics 14.0软件三维重建,演示虚拟术中复位和打印3D模型。将在我院规培的临床外科医生及本科实习生共60名,随机分为实验组和对照组,各30人。实验组采用3D打印技术结合传统病例教学的模式,对照组采用传统病例教学模式,以问卷调查及出科考试成绩的形式评估两组的教学效果;再分别挑选骨科副主任(专家组)8人和主治医生9名(年轻组),分别单独根据X线、CT三维重建和3D打印技术的影像学资料进行诊断,结合术中所见骨折情况,分别对17人的诊断正确率进行对比分析,得出结论。结果:1、两组学生的教学成效问卷调查结果显示实验组在自评得分(课程评估、教学评价、掌握程度、自学能力、理解能力、学习效率、课程专注度)都高于对照组(P0.01);出科考核成绩(理论知识、手术方案设计)显示实验组高于对照组(P0.01),均有统计学意义。2、使用X线、CT三维重建与3D打印技术对足踝骨折分类有统计学意义,对比诊断方法的准确率看,X线、CT三维重建及3D打印技术的正确率依次提高,3D打印技术比X线、普通CT重建更能清楚观察骨折情况。结论:1、3D打印技术结合传统教学方法应用于足踝病例教学,既可弥补传统教学的欠缺,还能提高年轻医师学习的积极性,降低学习难度,缩短学习曲线,具备良好的教学效果。2、3D打印技术可以让临床医生任意角度、直接观察骨折的立体解剖位置,获取更全面的骨折立体图形信息,提高诊断准确率。
[Abstract]:Objective: to reconstruct the patient's data by 3D printing technology and to obtain the object model near 1:1 by 3D printer, and to introduce 3D reconstruction software and model into the diagnosis, treatment and teaching of foot and ankle fracture, and to discuss its application value. Methods: the preoperative imaging data of 40 patients with foot and ankle fractures were selected from our hospital, including 10 cases of perimalleolar fractures, 18 cases of perimalleolar fractures and 12 cases of calcaneal fractures. The 3D reconstruction software Mimics 14.0 was used to demonstrate the reduction and printing of 3D models during virtual operation. A total of 60 clinical surgeons and undergraduate interns were randomly divided into experimental group and control group. The experimental group used 3D printing technology combined with the traditional case teaching model, the control group adopted the traditional case teaching model, the form of questionnaire survey and exam scores were used to evaluate the teaching effect of the two groups. Then the deputy director of orthopedic department (expert group 8 and attending doctor 9) (young group) were selected separately for diagnosis according to the imaging data of X-ray CT 3D reconstruction and 3D printing, respectively, and combined with the intraoperative fracture situation. The diagnostic accuracy of 17 patients was compared and analyzed, and the conclusion was drawn. Results the results of the questionnaire survey on the teaching effectiveness of the two groups of students showed that the experimental group had self-evaluation scores (curriculum evaluation, teaching evaluation, mastery, self-study ability, understanding ability, learning efficiency). The degree of course focus was higher than that of the control group (P 0.01). The design of operation plan) showed that the experimental group was higher than the control group (P 0.01), all had statistical significance. The classification of ankle fracture was statistically significant by using X-ray CT 3D reconstruction and 3D printing technology. Compared with the accuracy of the diagnostic methods, the accuracy of X-ray CT 3D reconstruction and 3D printing technology in turn increased than X-ray, ordinary CT reconstruction can clearly observe the fracture. Conclusion the application of 3 D printing technique combined with traditional teaching method in ankle case teaching can not only make up for the deficiency of traditional teaching, but also improve the enthusiasm of young doctors, reduce the learning difficulty and shorten the learning curve. The 3D printing technique with good teaching effect can make clinicians observe the stereoscopic anatomical position of fracture directly at any angle, obtain more comprehensive information of three-dimensional pattern of fracture, and improve the accuracy of diagnosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3;TP391.73

【参考文献】