计算机3D打印技术在儿童腓骨肌萎缩症的临床应用

Clinical Application of Computer 3D Printing Technology in Children with Peroneal Muscular Atrophy

目的:探讨并评价计算机3D打印技术在儿童腓骨肌萎缩症的临床疗效。方法:回顾性分析了2014年1月至2016年1月对收治的9例(15足)儿童腓骨肌萎缩症患儿的病例资料,利用整个足部CT平扫数据进行计算机三维建模、依靠计算机3D打印技术制作出与实体1:1等比例大小的腓骨肌萎缩症模型,根据患者的畸形情况,对模型进行术前制定手术方案,手术规划和模拟手术,并指导足部截骨矫正手术治疗。结果:9例患儿均获得16~40个月,平均21.5个月。所有患儿术后切口均一期愈合,无1例出现伤口感染。在手术过程中所见到的畸形情况与计算机三维重建图像及3D打印腓骨肌萎缩症模型一致,术前的模拟手术减少了手术的操作时间,达到更佳的手术效果。结论:计算机3D打印技术能够准确和直观地反映儿童腓骨肌萎缩症的立体形态和畸形部位的解剖结构关系,而且在儿童腓骨肌萎缩症截骨手术中能够进行术前设计和模拟,有助于精确矫正畸形,提高患儿的满意度和预后,疗效确切。

Objective: To investigate the application of digital three-dimensional reconstruction and 3 D printing in the treatment of Charcot-Marie-Tooth disease in children. Methods: The clinical data of 15 feet from 9 patients with equinovarus talipes cavus were retrospective analyzed in our hospital from January 2014 to January 2016. All of them were examined by lamellar CT to gain twodimensional data of diseased region. Three-dimensional reconstructions of anatomical models were accomplished by computer aided technology. By 3 D printing, the feet models were manufactured, operation project were formulated, preoperative sham operated were enforced and supervise the operation of osteotomy surgery of deformed feet in children. Results: All patients were followed up for 16~40 months, with an average of 21.5 months. All the incisions healed at the same time without any incision infection. Threedimensional reconstruction images and 3 D printing feet models were extremely similar to that doctor can see in operation. Preoperative sham operation saved the operation time and the actual angles corresponded almost exactly to the planned corrective angles in 9 cases. Conclusion: 3 D printing technology can reveal overall, direct-viewing, exactly display three-dimensional shape of complicated deformities, which can make operation excellent safer and more convenient. It can realize preoperative design and operation preview, correct the deformity, increase patient satisfaction and curative effect.