3D打印技术联合计算机辅助手术系统在下颌骨恶性肿瘤切除术后组织缺损修复中的应用

Application of 3D Printing Technology Combined with Computer-assisted Surgery System on Tissue Defect Repair after Mandible Malignant Tumor Resection

目的:探究3D打印技术联合计算机辅助手术系统对下颌骨恶性肿瘤切除术后组织缺损修复的指导效果。方法:选取2016年3月-2019年3月在笔者医院颌面外科就诊的80例下颌骨恶性肿瘤切除术后修复患者,采用随机数字法分为常规组(40例)和实验组(40例)。常规组:给予常规颌骨重建手术进行修复;实验组:给予3D打印技术联合计算机辅助手术系统进行修复。观察并比较两组的疗效、手术情况、面颊肿胀程度、疼痛程度以及并发症发生情况。结果:实验组总有效率为95.00%,显著高于常规组的72.50%(P<0.05);实验组手术时间、术中出血量显著低于常规组(P<0.05);两组的面部肿胀程度无显著性差异(P>0.05);实验组无疼痛发生率显著高于常规组(P<0.05),中度疼痛、重度疼痛发生率及视觉模拟评分法(VAS)评分显著低于常规组(P<0.05),轻度疼痛发生率无显著性差异(P>0.05);实验组颈部血肿、淋巴瘘及涎瘘的发生率和常规组比较,均无显著性差异(P>0.05),但以上三种并发症合计发生率显著低于常规组(P<0.05)。结论:3D打印技术联合计算机辅助手术系统对下颌骨恶性肿瘤切除术后组织缺损修复具有较好的临床指导效果,可显著改善手术情况,减轻疼痛程度,降低并发症发生率,值得临床进一步推广。

Objective To explore the guiding effect of 3D printing technology combined with computer-assisted surgery system on tissue defect repair after resection of mandibular malignant tumor.Methods 80 patients with mandibular malignant tumor treated in our hospital between March 2016 and March 2019 were selected and randomly divided into the conventional group(40 cases)and the experimental group(40 cases).The conventional group was given conventional jaw reconstruction surgery for repair,while the experimental group was given 3D printing technology combined with computer-assisted surgery system for auxiliary repair.The curative effect,operation,cheek swelling,pain and complications were observed and compared in the two groups.Results The total number of effective cases in the experimental group was 38,and the total effective rate was 95.00%,significantly higher than 72.50%in the conventional group(P<0.05).The operation time and intraoperative blood loss in the experimental group were significantly lower than those in the conventional group(P<0.05).There was no significant difference in the degree of facial swelling between the two groups(P>0.05).The incidence of no pain in the experimental group was significantly higher than that in the conventional group(P<0.05),the incidence of moderate pain,severe pain and score of visual analogue scale(VAS)were significantly lower than those in the conventional group(P<0.05),and the incidence of mild pain had no significant difference(P>0.05).The incidence of cervical hematoma,lymphatic fistula and salivary fistula in the experimental group was not significantly different from that in the conventional group(P>0.05),but the total incidence of the above three complications was significantly lower than that in the conventional group(P<0.05).Conclusion 3D printing technology combined with computer-assisted surgery system has a good clinical effect on tissue defect repair after resection of mandibular malignant tumor.It can significantly improve the operation situation,reduce the degree of pain and reduce the incidence of complications,and is worthy of further clinical research and promotion.