3D打印引导钛网在成年人颅骨缺损修补中的应用
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摘要
目的探讨3D打印引导钛网修补成年人颅骨缺损的临床应用价值。方法选取南通大学第二附属医院神经外科自2017年1月至2018年12月收治的需进行颅骨修补术患者39例,根据修补技术将患者分为2组,采用常规修补术的11例患者为对照组,基于3D打印技术进行钛网颅骨修补术的28例患者为试验组。比较2组患者术后相关临床资料。结果试验组与对照组在性别、年龄及平均缺损面积比较差异均无统计学意义(P>0.05)。试验组修补时间为(95.18±8.51)min,较常规手术(125.45±6.58)min明显缩短,同时试验组钛钉固定数目为(9.39±1.42)个,较常规手术的(11.55±1.86)个明显减少,差异有统计学意义(P<0.05)。而术后2组患者并发症发生率差异无统计学意义(P>0.05)。结论运用3D打印技术引导钛网进行精准塑形剪裁安全可行,能缩短修补时间,减少术后并发症及风险,可运用于临床颅骨修补术。
Objective To explore the clinical value of three-dimensional(3 D) printing-guided titanium mesh in repairing adult skull defects. Methods Thirty-nine patients who needed cranioplasty in Department of Neurosurgery, the Second Affiliated Hospital of Nantong University from January 2017 to December 2018 were selected. The patients were divided into two groups according to the repair technology. Eleven patients who underwent routine cranioplasty were the control group, and 28 patients who underwent titanium mesh cranioplasty based on 3 D printing technology were the experimental group.The clinical data of the two groups were compared statistically. Results There was no statistical difference in sex, age and average defect area between the experimental group and the control group( P>0.05). The repair time of the experimental group was(95.18±8.51) min, which was shorter than that of the conventional operation(125.45 ±6.58) min; and the fixed number of titanium nails in the experimental group was(9.39±1.42), which was lower than that in the conventional operation group(11.55 ±1.86), the difference was statistically significant(P<0.05). There was no significant difference in the complications between the two groups(P>0.05). Conclusion It is safe and feasible to use 3 D printing technology to guide precise plastic cutting of titanium mesh, which can shorten the repair time, reduce the complications and risks after operation. It can be used in clinical cranioplasty.
Objective To explore the clinical value of three-dimensional(3 D) printing-guided titanium mesh in repairing adult skull defects. Methods Thirty-nine patients who needed cranioplasty in Department of Neurosurgery, the Second Affiliated Hospital of Nantong University from January 2017 to December 2018 were selected. The patients were divided into two groups according to the repair technology. Eleven patients who underwent routine cranioplasty were the control group, and 28 patients who underwent titanium mesh cranioplasty based on 3 D printing technology were the experimental group.The clinical data of the two groups were compared statistically. Results There was no statistical difference in sex, age and average defect area between the experimental group and the control group( P>0.05). The repair time of the experimental group was(95.18±8.51) min, which was shorter than that of the conventional operation(125.45 ±6.58) min; and the fixed number of titanium nails in the experimental group was(9.39±1.42), which was lower than that in the conventional operation group(11.55 ±1.86), the difference was statistically significant(P<0.05). There was no significant difference in the complications between the two groups(P>0.05). Conclusion It is safe and feasible to use 3 D printing technology to guide precise plastic cutting of titanium mesh, which can shorten the repair time, reduce the complications and risks after operation. It can be used in clinical cranioplasty.
引文
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[15]卢磊,陈旭义,李一鹏,等.颅骨修补材料研究现状及3D打印技术应用前景[J].中国组织工程研究,2016,20(52):7885-7890.
[2]刘冬,秦虎,汪永新,等.3D打印羟基磷灰石/聚乳酸网状复合物修复颅骨缺损[J].中国组织工程研究,2019,23(6):833-837.
[3]殷俊飞扬,钟静,陈莉智,等.3D打印技术在颌面整形外科的应用进展[J].中国医学物理学杂志,2018,35(12):1479-1482.
[4]范芦芳,徐浩铜,张正治,等.利用Mimics软件构建人颅骨缺损区植入体的参数设置研究[J].第三军医大学学报,2011,33(19):2093-2095.
[5]许兴军,李泽福,崔岳文,等.3D打印技术在硬膜外血肿手术中的应用[J].中华神经创伤外科电子杂志,2018,4(3):167-170.
[6]陈俊,周赤忠,刘融.颅骨修补材料运用现状及3D打印技术在其制备工艺中的应用展望[J].中国临床神经外科杂志,2017,22(8):597-600.
[7]Andrabi SM,Sarmast AH,Kirmani AR,et al.Cranioplasty:Indications,procedures,and outcome-An institutional experience[J].Surg Neurol Int,2017,8(1):91.
[8]赵树森,盛文娟,张伟斌,等.基于CT数据的3D打印数据生成方法研究[C].第十五届中国体视学与图像分析学术会议论文集,2017:1.
[9]王蕾,张毅,王学建,等.3D打印技术在新西兰兔颅骨修补中的初步研究[J].生物医学工程与临床,2018,22(2):129-132.
[10]王蕾,张毅,严红燕,等.新西兰兔颅骨缺损钛网植入后钛离子释放的研究[J].生物医学工程与临床,2018,22(3):257-261.
[11]李浩,张学军,祁新禹,等.3D打印技术辅助手术治疗儿童重度脊柱侧凸的应用研究[J].临床小儿外科杂志,2018,17(9):654-658.
[12]张毅,王蕾,孙卫兵,等.基于3D打印的个体化钛修复体对幼兔颅面骨发育的研究[J].外科研究与新技术,2018,7(3):165-169.
[13]Panesar SS,Belo JTA,D’Souza RN.Feasibility of clinicianfacilitated three-dimensional printing of synthetic cranioplasty flaps[J].World Neurosurg,2018,113:e628-e637.
[14]李晓宇,宋超伟,费琦,等.骨修复3D打印钛合金支架材料的研究进展[J].临床和实验医学杂志,2019,18(2):222-225.
[15]卢磊,陈旭义,李一鹏,等.颅骨修补材料研究现状及3D打印技术应用前景[J].中国组织工程研究,2016,20(52):7885-7890.