三维技术在烧伤面积诊断及治疗中的应用

Application of three-dimensional technology in assessmentof burn area and treatment strategy of burns

准确的面积深度诊断、及时适量的液体复苏、合理的烧伤植皮手术是烧伤救治的关键，其中烧伤面积的准确计算对现场急救、休克复苏、手术方式选择、营养支持、护理及预后起着至关重要的作用。进入20世纪，通过大量的实践及研究比较，临床逐渐采用了以“Lund—Browder图表法”、“九分法”为主，“手掌面积法”为辅的烧伤面积评估方法。然而这些方法均为粗略的二维估算法，受主观因素影响大，且没有考虑年龄、性别、种族、体质、身体畸形（如肢体残缺）、生理状态等相关因素，因此不能体现患者的个体差异。大面积烧伤患者缺乏足量的自体皮肤用于植皮手术，现有的诸多植皮方法术后都会产生较多瘢痕。临床救治中对临时或永久的皮肤替代物的需求较高。近年来计算机辅助三维技术发展迅速，在诸多领域取得了突出成就。凭借其个体化、可重复、精确等特性，包括三维模型、三维扫描、三维打印等在内的一系列技术被引入并应用于临床，相信这些技术将会大大提高烧伤面积诊断的准确性以及植皮手术的疗效。

Accurate area assessment of a burn injury and its treatment according to its depth of injury are the foundation of burn treatment due to its complexity,and various techniques and methods have been employed to solve these problems for many years.As the demand of modern medicine calls for individualized and precise therapeutic measures,it is clear that the traditional diagnostic and treatment measures are insufficient.The flourishing development of three-dimensional （3D）technology seems to provide new research approaches and technical opportunities for burn surgery.A series of techniques such as 3D model,3D scanning,and 3D printing may be promising in advancing burn surgery through basic research to achieve rational clinical applications in the future.In this paper,the applications and achievements of 3D technology in burn surgery in recent years are summarized.