3D打印技术在颌骨骨折复位固定中的应用

Application of 3D printing technology in reconstruction and fixation of mxillofacial fracture

目的探讨3D打印技术在颌骨骨折复位固定中的应用价值。方法回顾性分析2018年1月至2019年6月连云港市第二人民医院口腔科采用颌骨内固定治疗的颌骨骨折患者28例资料。男18例,女10例;根据患者是否采用3D打印技术辅助手术分为两组:观察组在获得CT三维图像后3D打印出骨折模型后辅助完成手术,对照组仅采用CT扫描三维重建下完成手术,观察组15例,对照组13例。统计并比较两组手术时间、术中出血量、住院时间及术后并发症发生率。结果所有患者术后随访6~12个月,平均随访9.8个月。观察组手术时间为(76.08±5.02)min、住院时间为(12.36±1.39)d,均短于对照组的(99.12±3.18)min、(16.45±3.27)d;观察组术中出血量为(81.23±6.12)mL,少于对照组的(130.68±3.78)mL,差异均有统计学意义(t=5.324、3.135、9.798,均P<0.01)。两组术后关节粘连、切口感染发生率差异均无统计学意义(均P>0.05)。结论3D打印技术可以实现术前设计、手术模拟和内固定钛板精确塑形,有效提高颌骨骨折复位的精确性和安全性,缩短了手术时间。

Objective To explore the application value of 3D printing and image inversion in the reduction and fixation of jaw fracture.Methods A retrospective analysis was conducted in 28 patiens with jaw fracture who had treated by internal fixation of jaw bone in Department of Stomatology,the Second People's Hospital of Lianyungang from January 2018 to Junr 2019.There were 18 males and 10 females.The patients were divided into two groups according to whether they used 3D printing technology to assist surgery.The observation group(15 patients)used 3D printing technology to assist surgery after obtaining 3D CT images.The 13 patients in the control group were operated only with the assistance of three-dimensional reconstruction of CT scan.The operation time,intraoperative bleeding,hospitalization time and postoperative complications were compared between the two groups.Results All patients were followed-up for 6-12 months,with an average follow-up of 9.8 months.The observation group had significantly shorter operation time[(76.08±5.02)min]and hospital stay[(12.36±1.39)d],less intraoperative blood loss[(81.23±6.12)mL]compared with the control group[(99.12±3.18)min,(16.45±3.27)d,(130.68±3.78)mL](t=5.324,3.135,9.798,all P<0.01).There were no statistically significant differences in the incidences of joint adhesion and incision infection between the two groups(all P>0.05).Conclusion 3D printing technology can achieve preoperative design,surgical simulation and internal fixation of titanium plate precise shape,effectively improve the accuracy and safety of jaw fracture reduction,greatly shorten the operation time.