3D打印技术在胸廓畸形矫形手术的临床应用研究
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摘要
目的:探讨3D打印技术在胸廓畸形矫形手术的临床应用。方法:选取2016年2月-2018年2月本院收治的胸廓畸形(漏斗胸)患者100例。依据随机数字表法分为3D组和矫形组,各50例。矫形组给予常规手术治疗,3D组在此基础上给予3D打印技术辅助。比较两组术中出血量、手术时间、住院时间、并发症、Haller指数及优良率。结果:3D组术中出血量、手术时间、住院时间均少于矫形组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);术后3、6个月,两组Haller指数均低于术前,且3D组均低于矫形组,差异均有统计学意义(P<0.05);3D组治疗优良率明显高于矫形组(P<0.05)。结论:3D打印技术辅助可有效减少术中创伤,有利于提高手术疗效,且具有良好的安全性,值得临床做进一步推广。
Objective:To discuss the clinical application of 3 D printing technology in thoracic deformity correction surgery.Method:A total of 100 patients with thoracic malformation(pectus excavatum)admitted to our hospital from February 2016 to February 2018 were selected.According to the random number table method,they were divided into 3 D group and orthopaedic group,50 cases in each group.The orthopaedic group was treated with routine surgery,the 3 D group was assisted by 3 D printing technology.The intraoperative bleeding volume,operation time,hospitalization time,complications,Haller index,excellent and good rate between two groups were compared.Result:The intraoperative bleeding volume,operation time and hospitalization time in 3 D group were less than those of orthopaedic group,the differences were statistically significant(P<0.05).The incidence of complications in two groups was compared,the difference was not statistically significant(P>0.05).At 3 and 6 months after operation,the Haller index in both groups were lower than those of before operation,and 3 D group were lower than those of orthopaedic group,the differences were statistically significant(P<0.05).The excellent and good rate of treatment in 3 D group was significantly higher than that of orthopaedic group(P<0.05).Conclusion:3 D printing technology can effectively reduce intraoperative trauma,improve surgical efficacy,and has good safety,which is worthy of further clinical promotion.
Objective:To discuss the clinical application of 3 D printing technology in thoracic deformity correction surgery.Method:A total of 100 patients with thoracic malformation(pectus excavatum)admitted to our hospital from February 2016 to February 2018 were selected.According to the random number table method,they were divided into 3 D group and orthopaedic group,50 cases in each group.The orthopaedic group was treated with routine surgery,the 3 D group was assisted by 3 D printing technology.The intraoperative bleeding volume,operation time,hospitalization time,complications,Haller index,excellent and good rate between two groups were compared.Result:The intraoperative bleeding volume,operation time and hospitalization time in 3 D group were less than those of orthopaedic group,the differences were statistically significant(P<0.05).The incidence of complications in two groups was compared,the difference was not statistically significant(P>0.05).At 3 and 6 months after operation,the Haller index in both groups were lower than those of before operation,and 3 D group were lower than those of orthopaedic group,the differences were statistically significant(P<0.05).The excellent and good rate of treatment in 3 D group was significantly higher than that of orthopaedic group(P<0.05).Conclusion:3 D printing technology can effectively reduce intraoperative trauma,improve surgical efficacy,and has good safety,which is worthy of further clinical promotion.
引文
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[4]王雅辉,刘正蓬,褚立,等.计算机辅助设计联合3D打印技术在胸腰椎骨折椎弓根螺钉置入术中的应用[J].山东医药,2018,58(16):64-66.
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[6]何志勇,张擎柱,林影影,等.传统手术与应用3D打印技术后手术治疗复杂胫骨平台骨折的疗效比较[J].中国矫形外科杂志,2016,24(8):682-686.
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[9]黎伟文,杨家恒.3D打印技术在非对称性漏斗胸手术的临床应用[J].中国医学创新,2016,13(35):127-131.
[10]Johnson W R,Fedor D,Singhal S.Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum[J].J Cardiothorac Surg,2014,9(1):1-13.
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[12]钟伟弘,叶金铎,刘吉福,等.漏斗胸微创矫形手术的生物力学研究进展[J].医用生物力学,2015,30(3):280-284.
[13]白洁,闫天生.Nuss微创手术治疗漏斗胸的现状及进展[J].中国微创外科杂志,2015,15(8):752-754,758.
[14]黄华军,张国栋,欧阳汉斌,等.基于3D打印技术的复杂胫骨平台骨折内固定手术数字化设计[J].南方医科大学学报,2015,35(2):218-222.
[15]卢笛,蔡开灿.3D打印技术在胸外科领域中的应用进展[J].实用医学杂志,2017,33(12):1901-1903.
[16]姜睿.三维重建及3D打印在胸外科的应用[J].青岛大学医学院学报,2017,53(5):625-627,630.
[17]杨泗华,张翔,于一凡,等.3D打印辅助经后路椎弓根钉棒内固定治疗强直性脊柱炎合并胸腰段椎体骨折的临床应用研究[J].中国数字医学,2016,11(7):77-80,87.
[18]李富涛,李焰,马杰,等.计算机辅助虚拟手术设计结合3D打印技术在颌骨重建的应用研究[J].创伤外科杂志,2017,19(9):657-661.
[19]孟祥鹏,张建卿,王庆志,等.计算机影像数据心脏三维重建及3D打印技术研究[J].中国心血管病研究,2015,13(12):1136-1138,1152.
[20]柳鑫,曾参军,卢键森,等.3D打印计算机虚拟辅助技术在髋臼骨折术前规划中的应用[J].南方医科大学学报,2017,37(3):378-382.
[2]Ramos Mejía R,del Pino M,Obregón M G,et al.Clinical,radiological and auxologic long-term evolution of 8 children with asphyxiating thoracic dysplasia[J].Arch Argent Pediatr,2015,113(6):e357-e362.
[3]吴家宝,钟金慧,邓江波,等.微创Nuss手术在胸壁畸形治疗中的临床应用研究[J].中国医学创新,2016,13(18):105-108.
[4]王雅辉,刘正蓬,褚立,等.计算机辅助设计联合3D打印技术在胸腰椎骨折椎弓根螺钉置入术中的应用[J].山东医药,2018,58(16):64-66.
[5]邓爱文,熊日波,何伟明,等.髋臼骨折中应用3D打印技术术后的康复策略[J].南方医科大学学报,2014,34(4):591-593.
[6]何志勇,张擎柱,林影影,等.传统手术与应用3D打印技术后手术治疗复杂胫骨平台骨折的疗效比较[J].中国矫形外科杂志,2016,24(8):682-686.
[7]Koumbourlis A C.Chest wall abnormalities and their clinical significance in childhood[J].Paediatr Respir Rev,2014,15(3):246-254.
[8]张建新,罗平,包铮.非胸腔镜辅助改良Nuss手术矫治漏斗胸的临床分析[J].中国临床研究,2015,28(1):64-66.
[9]黎伟文,杨家恒.3D打印技术在非对称性漏斗胸手术的临床应用[J].中国医学创新,2016,13(35):127-131.
[10]Johnson W R,Fedor D,Singhal S.Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum[J].J Cardiothorac Surg,2014,9(1):1-13.
[11]Chiummariello S,Pica A,Guarro G,et al.Poland syndrome:an algorithm to select the appropriate chest wall surgical reconstructive treatment[J].Ann Ital Chir,2014,85(3):237-243.
[12]钟伟弘,叶金铎,刘吉福,等.漏斗胸微创矫形手术的生物力学研究进展[J].医用生物力学,2015,30(3):280-284.
[13]白洁,闫天生.Nuss微创手术治疗漏斗胸的现状及进展[J].中国微创外科杂志,2015,15(8):752-754,758.
[14]黄华军,张国栋,欧阳汉斌,等.基于3D打印技术的复杂胫骨平台骨折内固定手术数字化设计[J].南方医科大学学报,2015,35(2):218-222.
[15]卢笛,蔡开灿.3D打印技术在胸外科领域中的应用进展[J].实用医学杂志,2017,33(12):1901-1903.
[16]姜睿.三维重建及3D打印在胸外科的应用[J].青岛大学医学院学报,2017,53(5):625-627,630.
[17]杨泗华,张翔,于一凡,等.3D打印辅助经后路椎弓根钉棒内固定治疗强直性脊柱炎合并胸腰段椎体骨折的临床应用研究[J].中国数字医学,2016,11(7):77-80,87.
[18]李富涛,李焰,马杰,等.计算机辅助虚拟手术设计结合3D打印技术在颌骨重建的应用研究[J].创伤外科杂志,2017,19(9):657-661.
[19]孟祥鹏,张建卿,王庆志,等.计算机影像数据心脏三维重建及3D打印技术研究[J].中国心血管病研究,2015,13(12):1136-1138,1152.
[20]柳鑫,曾参军,卢键森,等.3D打印计算机虚拟辅助技术在髋臼骨折术前规划中的应用[J].南方医科大学学报,2017,37(3):378-382.