3D打印微血管减压手术训练模型的制作与评价

Manufacture and evaluation of training model of MVD with 3D printing

目的:制作基于三维(3D)打印技术的面肌痉挛微血管减压(MVD)手术训练模型,探讨其临床应用效果。方法:利用Mimics软件从面肌痉挛(HFS)患者的医学影像数据中提取组织器官二维图像并进行3D建模,使用多色彩多材质3D打印技术制作颅脑模型,附加颅神经报警系统和模拟蛛网膜下腔组件后组装成MVD手术训练模型,采用李克特量表对模型的真实程度及训练效果进行评估。结果:李克特量表评分中3名神经外科医生对模型组织仿真程度的评分为4.1分,10名接受培训的医师对于模型提高手术技术的评分为4.3分,接受手术训练后牵拉小脑的最大牵拉力明显下降,器械触碰颅神经的频率明显减少。结论:多色彩多材质3D打印技术制作的MVD手术训练模型能够对手术的关键步骤进行有针对性的手术技术培训,脑压板压力测量及神经触碰报警系统的使用可以提高手术训练的效果。

Objective:To manufacture a specialized training model of microvascular decompression(MVD)for hemifacial spasm(HFS)based on 3D printing technique and explore its clinical application effect.Methods:Mimics software was used to extract 2D images of tissue and organ from medical image data of patients with HFS and to establish 3D model.The 3D printing technique with multiple-colours and multiple materials were used to manufacture brain model,and it was combined with alarm system of cranial nerve and simulated subarachnoid space component to assemble MVD training model.And Likert scale was used to assess the reality of model and training effect.Results:In the results of Likert scale,the scores of 3 neurosurgeons for simulation degree of this model were 4.1 score,and the scores of 10 physicians who received training for enhancing surgical technique of this model were 4.3 score.After these 10 physicians received training,the maximum drag force of them obviously decreased and the frequency that operative instrument touched cranial nerve obviously reduced.Conclusion:The 3D-printed surgical model of MVD which uses multiple colors and multiple materials can implement surgery technical training with pertinence for critical process in operation.And the applications of brain spatula measurement and alarm system of touching nerve can enhance the effect of operation training.