3D打印个体化治疗方案在骨盆骨折中的应用

Application of 3D printing technology and individualized treatment in pelvic fracture

目的探讨3D打印个体化手术治疗方案在骨盆骨折中的临床疗效。方法收集南京医科大学第二附属医院骨盆骨折的患者22例,随机分为3D组和对照组,3D组病例采用3D打印技术建模,术前模拟手术,定制个体化解剖钢板后进行手术治疗,对照组常规手术治疗,所有病例记录手术所用时间、出血量和内固定物的长度、弧度、螺钉数量和方向,术后应用Matta评分评估疗效,比较两组病例手术时间、术中出血量的差异。结果所有病例术后随访2~8月,Mata评估标准均为优,3D组手术时间为(60±12)min,较对照组明显缩短,术中出血量为(218±63)m L,较对照组明显减少,手术入路与术前设计一致,内固定位置与术前手术方案设计完全一致。结论 3D打印个体化治疗方案治疗骨盆骨折,可以给每一位骨盆骨折患者设计个体化解剖形内固定物,制定个性化手术方案,并且具有减少手术创伤、缩短手术时间、降低手术难度等优势,临床疗效满意,值得推广。

Objective To investigate the curative effect of the application of 3D printing technology and individualized treatment in pelvic fracture. Methods Twenty-two cases with complex pelvic fracture were gathered from the second af- filiated hospital of Nanjing medical university. The cases were randomly divided into 3D group and control group. All the cases in 3D group were built models by 3D printing technology, simulation operations were planed, and individualized anatomic plates were instituted preoperatively. The cases in control group were treated with routine surgery. Operation time and intraoperative blood loss were recorded. The length and radian of plates, the quantity and direction of screws were recorded. Treatment effects were evaluated by Matta evaluation standard postoperatively. Compared the difference of operation time and intraoperative blood loss between two groups. Results All cases were followed up for 2 ？8 months after surgery. All cases were excellent according to Matta evaluation standard. All cases in 3D group had shorter operation time, less intraoperative blood loss. The surgical approach and internal fixation were consistent with preoperative design.Conclusion The 3D printing technology and individualized treatment in pelvic fracture has the advantages of personalized internal fixation, personalized operative plan, less intraoperative blood loss, shorter operation time and simplified op-eration, et al. The clinical curative effect is satisfied.