数字化模型辅助下钛网三维塑形修补颅骨

Digital model-assisted titanium mesh three-dimensional molding for cranium osteoplasty

背景:数字化塑形的钛网已应用于颅骨缺损的修补,但存在设备技术条件要求较高,塑形周期较长,费用较高的问题。许多研究者试图找到一种不仅简便而且保留数字化塑形优点的制造方法,而制造出颅骨缺损的三维实物模型无疑是解决这一问题的关键。目的:观察数字化模型辅助下进行钛网三维塑形的可行性及临床应用价值。方法:颅骨缺损修补患者92例,根据钛网塑形方法分为2组:数字化模型辅助塑形组32例,利用常见设备快速制作出颅骨缺损的数字化模型,在模型辅助下进行钛网的三维塑形。手工塑形组60例,按照颅骨缺损形状利用钛网成型工具将三维钛网进行手工塑形。结果与结论:数字化模型辅助塑形组患者的手术时间明显少于术中手工塑形组(P<0.01)。数字化模型辅助塑形组使用固定用钛钉平均为5.781个,术中手工塑形组使用钛钉平均为7.050个,两组差异有显著性意义(P<0.01)。数字化模型辅助塑形组术后并发症发生率为3.1%,术中手工塑形组为13.3%,两组差异无显著性意义(P>0.05)。数字化模型辅助塑形组术后满意度明显优于术中手工塑形组(P<0.05)。可见钛网的数字化模型辅助塑形简化了塑形过程、降低了对设备条件的要求,解决了颅骨缺损手术的费用与美观的均衡问题,便于在临床推广。

BACKGROUND：The titanium mesh with computer-aided design and individual shaped titanium armor plate has been widely used in repairing skull defects,but there exist many problems such as equipment,time,expenses etc. Researches attempt to develop a simple method that can retain digital molding to establish three-dimensional solid model of cranial defects. OBJECTIVE：To evaluate the feasibility and clinical application value of digital model for cranium osteoplasty. METHODS：A total of 92 patients undergoing cranioplasty were selected and divided into 2 groups：digital model-aided molding group （n=32）,treated with the digital model made by simple device and the titanium mesh mold according to the digital model; manually molding group （n=60）,treated with manually mold titanium mesh. RESULTS AND CONCLUSION：Compared with the manually molding group,the operation time was shorter （P 0.01） and the number of titanium screws was fewer （5.781 vs. 7.050） in the digital model-aided molding group （P 0.01）. There were no significant differences in complications between two groups （P 0.05）. The satisfactory rate of patients was higher in digital model-aided molding group compared with the manually molding group （P 0.05）. Results showed that titanium mesh with computer-aided design and individual shaped titanium armor plate simplifies molding,reduces requirement for equipment and balances operation cost and outlooking.