计算机辅助设计数字化三维成形钛网修补颅骨缺损

Computer-aided design of the digitalized 3D reconstruction titanium armor plate in repairing skull defects

目的探讨利用计算机辅助设计与制造（CAD/CAM）技术进行个性化塑形颅骨缺损修补术的临床价值。方法2007年6月～2008年6月，选择笔者所在医院颅骨缺损患者20例作为计算机辅助设计组，其中男性12例，女性8例，年龄20。57岁，平均年龄33岁。术前将其颅骨缺损前后CT数据在计算机上分别进行三维重建，采用颅骨缺损部位的三维几何模型数据．应用人工智能技术，设计补片几何形状，制作出凸凹2个模具，利用模具将颅骨修补材料钛网压制成形，用成形好的钛网修补颅骨缺损。另选20例颅骨缺损患者作为对照组。结果塑形、麻醉及手术操作时间明显减少，术后无一例出现因塑形欠佳造成的并发症，复查头颅CT修复以后的颅骨形状与原颅骨形状完全一致。结论颅骨缺损修补手术应用CAD／CAM技术塑形颅骨修补材料实现了个体化配置修补颅骨缺损，使患者颅骨修补后头颅形状最大限度恢复生理原貌，患者满意度100％。此方法重复性强，具有一定的创新性和实用性，值得在临床大力推广。

Objective To evaluate the clinical efficacy of computer-aided design （CAD） of individual shaped titanium armor plate in repairing skull defects. Methods Twenty patients （CAD group） with skull defect were treated in the department of neurosurgery, General Hospital of Lanzhou Milhary Command from June 2007 to June 2008, male 12, female 8, aged 20 - 57 years, mean age 33 years. The CT data were distinguishly 3D reconstructed before-after- cranieetomy, and the 3D geometric model of skull defect was established. Then a geometric shaped patch was designed and made with both concavity and convex by intellectual technology, finally a piece of shaped titanium armor plates was prepared before operation. In this study twenty patients in this hospital were enrolled in control group. Results Performed by this technique the neurosurgeons/shaping workload, anaesthetic and operational time were decreased significantly compared to that by traditional handwork shaping. There was no complication for the shaping below the mark. The patients regained original shape of cranial bones. Conclusion The individualized treatment is established to repair skull defect by CAD/CAM. The satisfaction rate of patients performed by this procedure reaches 100 % after operation. Thus it is a good approach and would he recommended in clinical practice.