3D打印技术在骨肿瘤外科临床中的应用

发布时间：2018-10-26 10:32

【摘要】：目的探讨3D打印技术制备的个体化模型及导板在骨肿瘤外科中的应用效果。方法 2015年10月—2016年12月,将3D打印技术制备的个体化模型及导板用于术前制定手术方案及术中治疗5例骨肿瘤患者。患者均为男性;年龄9~58岁,中位年龄32岁。其中左侧骨盆、股骨近端囊型包虫病合并股骨近端病理性骨折1例,左髂骨骨母细胞瘤合并动脉瘤样骨囊肿1例,左股骨纤维结构不良(牧羊拐畸形)合并病理性骨折1例,右跟骨转移癌1例(分期T2N0M0),左股骨中段尤文肉瘤1例(分期T2N0M0)。病程1个月~10年,平均2.25年。结果手术均顺利完成。手术时间2.6~7.5 h,平均4.9 h;术中出血量200~2 500 m L,平均1 380 m L;术中透视次数1~6次,平均3.8次。术后切口无感染,血运及神经功能良好。5例患者均获随访,随访时间3~16个月,平均5.4个月。内固定物无松动或断裂发生。术后3个月肢体功能评分采用Enneking评分系统,为15~26分,平均21分;获优2例、良2例、中1例。结论 3D打印技术用于骨肿瘤外科能更好地实现术前规划及评估,为骨肿瘤患者的个体化治疗提供了新方法。
[Abstract]:Objective to investigate the application of 3D printing technique in bone tumor surgery. Methods from October 2015 to December 2016, the individualized model and guide plate of 3D printing technique were used to make the operation plan before operation and to treat 5 patients with bone tumor during operation. All patients were male, aged 9 to 58 years, with a median age of 32 years. There were 1 case of left pelvis, 1 case of proximal femur hydatidosis associated with pathological fracture of proximal femur, 1 case of left iliac osteoblastoma with aneurysm-like bone cyst, 1 case of left femoral fibrous dysplasia (sheep crutch deformity) and 1 case of pathological fracture. One case of right calcaneal metastatic carcinoma (T2N0M0) and one case of left middle femur Ewing's sarcoma (staging T2N0M0). The course of disease ranged from 1 month to 10 years (mean 2.25 years). Results all the operations were completed successfully. The operative time was 2.6 ~ 7.5 h (mean 4.9 h), the blood loss during operation was 2 500 mL (mean 1 380 mL), and the times of fluoroscopy was 1 6 times (mean 3.8 times). There was no infection in the incision and the blood flow and nerve function were good. 5 cases were followed up for 3 ~ 16 months with an average of 5.4 months. There was no loosening or fracture of the internal fixator. Enneking scoring system was used to evaluate limb function 3 months after operation, with an average of 21 points (15 ~ 26 points), excellent in 2 cases, good in 2 cases, and middle in 1 case. Conclusion 3D printing is a better method for preoperative planning and evaluation of bone tumor surgery and provides a new method for individualized treatment of bone tumor patients.
【作者单位】：新疆医科大学第一附属医院骨科中心骨肿瘤外科;
【分类号】：R738.1;TP391.73

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