3D打印在先天性心脏病诊疗中的应用

3D打印技术因具有标准化建模、个体化诊疗等优点,近年来在骨科、口腔科、神经外科等领域已开始逐步进行了临床应用。部分小儿先天性心脏病病变复杂,传统的二维图像难以清晰地显示复杂心内畸形的空间解剖结构,而精确评估心脏解剖结构及与周围组织关系对治疗方案的选择及改善预后至关重要。3D打印技术为该类复杂及疑难先天性心脏病的精准诊断和治疗提供了新的思路。3D打印病变心血管模型有助于人们了解心内畸形精确的解剖空间关系、设计最佳手术方案、选择个体化的介入治疗器械等。3D打印技术在先天性心脏病中的应用正逐渐成为当前的研究热点。本文针对3D打印技术在先天性心脏病诊疗中的应用及展望进行综述。     

3D打印技术在骨科临床教学实施中的效果

目的探究3D打印技术在骨科临床教学实施中的效果。方法结合患者的影像学资料通过3D打印技术的应用,对患者骨折或者畸形进行数字化真实再现,为骨科的临床教学提供相对直观、真实的教学模型。结果应用3D打印技术所制作骨骼三维立体模型有助于帮助学生在短时间内对骨科疾病的影像学以及分型的特点进行理解和掌握,同时对于手术的方案及技巧也有基本的理解,从而更好的达到精准手术的要求。且本次教学学生的满意度为100%。结论3D打印技术在骨科临床教学实施中起到的教学效果极佳,且该技术的应用方便、快捷,存在良好的前景,该技术在临床骨科教学中的应用具有较高的价值。     

3D打印技术在颅内动静脉畸形血管内介入治疗中的初步应用

目的探讨3D打印技术在指导颅内动静脉畸形(AVM)血管内介入治疗中的临床应用价值。方法贯序交替选取2015年2月至5月广东省人民医院神经外科进行血管内介入治疗的AVM患者10例,其中5例为对照组,5例为进行3D打印模型试验组。对试验组5例AVM患者采用256层螺旋CT薄层增强扫描或3D-DSA旋转成像,提取检查结果的DICOM原始数据,应用薄层数据扫描获取5例AVM患者三维数据,通过Mimics 14.01软件进行数字化数据提取和重建,并按1∶1比例进行3D打印,获得实体模型。应用AVM实体模型指导与患者及其家属的术前谈话及手术方案设计,并与对照组结果进行对比。结果 3D打印模型试验组术前谈话时间(10.2±0.8)min较对照组术前谈话时间(15.0±1.3)min显著缩短,差异有统计学意义(P0.01);试验组患者及其家属满意度评分显著高于对照组[(9.3±0.6)分比(8.1±0.3)分,P0.01],试验组术中造影后至手术实施时间较对照组显著缩短[(5.7±0.4)min比(10.5±1.6)min,P0.01]。无一例手术相关并发症。结论 3D打印模型可以帮助术者更加直观地了解畸形团空间构筑学特征,指导术者进行手术方案的制定,同时应用3D打印实体模型可提高与AVM患者术前谈话效率及患者满意度。     

三维可视化技术在消化内镜的应用进展

近年来,数字智能化医学迅速发展,相较于传统的二维成像,三维可视化技术可提供直观、立体的三维图像,便于临床医生多层次、多角度观察病变及其毗邻结构。3D打印技术将可视化图像转化为肉眼可见的物理模型,可进一步提升对复杂疾病形态特征的理解。此外,虚拟现实和混合现实等高级可视化技术,可增加更多真实、互动的医学体验。本文阐述了三维可视化、3D打印及现实技术的基本概念,并对其在消化内镜领域的应用研究进行总结与展望。     

3D打印技术在临床医学中的应用进展

近年来,3D打印技术迅速发展,在临床医学领域尤其在与再生重建相关的外科中应用广泛。3D打印技术可用于制备医学模型,进行手术策划,手术辅助器械和个性化内植入物,生物打印与组织工程等方面。本综述着重介绍了3D打印技术在临床医学中的应用,并分析目前存在的问题及展望发展前景。     

3D打印技术在血管疾病诊治中的应用

正3D打印技术被制造业誉为第三次工业革命,在21世纪已经在许多领域都展现了巨大的价值和潜力,在医学领域如骨科、口腔科、整形外科、神经外科等都得到了广泛的应用。3D打印的开展应用也为血管疾病的诊治提供了新的方法,本文综述介绍3D打印技术在血管疾病诊治中的应用现状及未来发展趋势。1 3D打印技术的概念及种类3D打印技术(3DP)是一种快速成型技术,原理是将计算机辅助设计出的数字模型输入3D打印机中,通过逐     

CT与3D-DSA数据源在颅内动静脉畸形3D打印中的初步应用

目的比较CT薄层增强扫描与3D-DSA数据源在颅内动静脉畸形(AVM)3D打印数据重组中的效果。方法前瞻性选取5例AVM患者,Spetzler-Martin分级Ⅱ级3例,Ⅲ级2例。对其中2例采用256层螺旋CT薄层增强扫描,3例采用3D-DSA旋转成像,提取检查结果的DICOM原始数据,通过Mimics14.0软件进行数字化处理,并按1∶1比例进行3D打印,获得实体模型并进行效果比较。结果基于256层螺旋CT薄层增强扫描数据源的3D打印可获取颅骨及血管的图像信息,能显示最细直径0.9 mm的血管,但AVM内部细支结构难于分辨;基于3D-DSA数据的3D打印,数字减影无颅骨数据信息,但血管分支情况显示更丰富,可显示最细直径0.5 mm的血管。结论应用CT薄层增强扫描或3D-DSA数据源均可获得AVM畸形团3D重组图像,而3D-DSA显示AVM畸形团空间构造效果更佳,有助于术前治疗方案的设计及相应辅助工具的开发。     

多学科结构化查房模式联合3D打印技术在老年胃造瘘患者中的应用研究

目的 评估多学科结构化查房模式联合3D打印技术在老年胃造瘘患者中的应用效果。方法 选取2021年8月—2022年7月在上海交通大学医学院附属第九人民医院行胃造瘘术的老年患者129例，采用数字表法随机分为传统组、 3D打印组、多学科+3D打印组，每组43例。传统组实施常规诊疗措施，3D打印组在传统组处理基础上使用3D打印技术定制个性化胃造瘘导管固定装置，多学科+3D打印组在传统组处理基础上实施多学科结构化查房模式联合3D打印技术定制个性化胃造瘘导管固定装置。对比3组的生活质量、自我效能、对胃造瘘导管固定方法的满意度、术后并发症、住院时间等情况。结果 3组入院时的生活质量评分、自我效能评分差异均无统计学意义(P>0.05)。术后1个月，3组的生活质量评分、自我效能评分差异有统计学意义(P<0.05);两两比较，3D打印组的生活质量评分、自我效能评分与传统组的差异无统计学意义(P>0.05),多学科+3D打印组的生活质量评分、自我效能评分与3D打印组、传统组的差异均有统计学意义(P<0.05)。多学科+3D打印组和3D打印组对胃造瘘导管固定方法的满意度高于传统组，差异...     

3D打印在心血管疾病手术中的应用进展

近年来,3D打印在临床上已经广泛应用。本综述首先阐述在心血管疾病中3D打印模型的来源,然后重点介绍3D打印在先天性心脏病、心脏瓣膜病和肥厚型心肌病等诸多方面手术治疗中的应用,最后指出3D打印未来的发展方向,并对3D打印的应用进行讨论。     

数字化3D打印技术在口腔医学中的临床应用进展

数字化3D打印是医疗卫生行业发展迅速的一项技术，在口腔临床医学领域表现出巨大潜力，包括牙体牙髓病学、口腔修复学、正畸学、颌面外科和口腔种植学。新型数字化3D打印可以辅助设计并制作个性化导板、模型、假体和生物支架等，具有高精准、微创化、操作时长短和工作效率高等优点。借助医理工多学科交叉和数字化程序辅助设计，数字化3D打印技术可为口腔疾病的预防和诊疗提供更具个性化和多元化的方案或策略。对数字化3D打印技术在口腔医学各个领域的临床应用进行总结，可为不同的口腔临床医学领域应用数字化3D打印技术提供参考依据。     

A practical guide to cardiovascular 3D printing in clinical practice: Overview and examples

The advent of more advanced 3D image processing, reconstruction, and a variety of three‐dimensional (3D) printing technologies using different materials has made rapid and fairly affordable anatomically accurate models much more achievable. These models show great promise in facilitating procedural and surgical planning for complex congenital and structural heart disease. Refinements in 3D printing technology lend itself to advanced applications in the fields of bio‐printing, hemodynamic modeling, and implantable devices. As a novel technology with a large variability in software, processing tools and printing techniques, there is not a standardized method by which a clinician can go from an imaging data‐set to a complete model. Furthermore, anatomy of interest and how the model is used can determine the most appropriate technology. In this over‐view we discuss, from the standpoint of a clinical professional, image acquisition, processing, and segmentation by which a printable file is created. We then review the various printing technologies, advantages and disadvantages when printing the completed model file, and describe clinical scenarios where 3D printing can be utilized to address therapeutic challenges.

     

Computed Tomography–Derived 3D Modeling to Guide Sizing and Planning of Transcatheter Mitral Valve Interventions

A plethora of catheter-based strategies have been developed to treat mitral valve disease. Evolving 3-dimensional (3D) multidetector computed tomography (MDCT) technology can accurately reconstruct the mitral valve by means of 3-dimensional computational modeling (3DCM) to allow virtual implantation of catheter-based devices. 3D printing complements computational modeling and offers implanting physician teams the opportunity to evaluate devices in life-size replicas of patient-specific cardiac anatomy. MDCT-derived 3D computational and 3D-printed modeling provides unprecedented insights to facilitate hands-on procedural planning, device training, and retrospective procedural evaluation. This overview summarizes current concepts and provides insight into the application of MDCT-derived 3DCM and 3D printing for the planning of transcatheter mitral valve replacement and closure of paravalvular leaks. Additionally, future directions in the development of 3DCM will be discussed.     

3D打印在神经外科应用的新进展

3D打印自20世纪90年代迅速兴起并逐步应用于各行各业。近年来3D打印在医学领域的应用一定意义上带动了神经外科发展,其带来的变化或许将改变整个医疗行业面貌,其在未来还有多种应用可能。本文就3D打印在神经外科的应用作一综述。     

A New Method for Testing the Breaking Force of a Polylactic Acid-Fabric Joint for the Purpose of Making a Protective Garment

3D printing is a technology that is increasingly used in the individualization of clothing, especially in the construction of garments for people with disabilities. The paper presents a study on the use of 3D printed knee protectors intended for wheelchair users. Due to the specific purpose of this 3D printed object, the breaking force of the polylactic acid (PLA) combined with 100% cotton and 100% polyester fabric was investigated. This paper will also describe a new method for testing the breaking force of a 3D printed polymer (PLA) combined with an incorporated fabric. Test samples were made, and the input parameters used in 3D printing were defined for testing purposes. A 3D knee protector for wheelchair users was developed based on a digitized model of the human body. The durability of the shape of the 3D printed shield was also tested after washing at temperatures of 40 °C, 50 °C and 60 °C. A clothing model that provides adequate user protection was proposed based on the conducted research. A construction solution has been proposed that enables the application of a 3D printed individualized garment element.     

3D打印材料聚醚醚酮支架在耳廓再造中的应用前景

3D打印材料聚醚醚酮(PEEK)是一种在医学领域有许多潜在用途的聚合物,随着3D打印技术的逐渐兴起,不仅能针对患者的病情需求打印出个性化植入,而且PEEK具备作为植入物的必备性能,这两大优点表明其在耳廓的修复与重建领域中有望替代传统修复材料.该文对3D打印材料PEEK作为植入物所具备的优良性能,以及在耳廓再造领域的应用...     

Fiber Thickness and Porosity Control in a Biopolymer Scaffold 3D Printed through a Converted Commercial FDM Device

3D printing has opened exciting new opportunities for the in vitro fabrication of biocompatible hybrid pseudo-tissues. Technologies based on additive manufacturing herald a near future when patients will receive therapies delivering functional tissue substitutes for the repair of their musculoskeletal tissue defects. In particular, bone tissue engineering (BTE) might extensively benefit from such an approach. However, designing an optimal 3D scaffold with adequate stiffness and biodegradability properties also guaranteeing the correct cell adhesion, proliferation, and differentiation, is still a challenge. The aim of this work was the rewiring of a commercial fuse deposition modeling (FDM) 3D printer into a 3D bioplotter, aiming at obtaining scaffold fiber thickness and porosity control during its manufacturing. Although it is well-established that FDM is a fast and low-price technology, the high temperatures required for printing lead to limitations in the biomaterials that can be used. In our hands, modifying the printing head of the FDM device with a custom-made holder has allowed to print hydrogels commonly used for embedding living cells. The results highlight a good resolution, reproducibility and repeatability of alginate/gelatin scaffolds obtained via our custom 3D bioplotter prototype, showing a viable strategy to equip a small-medium laboratory with an instrument for manufacturing good-quality 3D scaffolds for cell culture and tissue engineering applications.     

3D Printing Optimization for Environmental Sustainability: Experimenting with Materials of Protective Face Shield Frames

The motivation for research on 3D printing of protective face shields was the urgent societal demand for healthcare in the fight against the spread of COVID19 pandemic. Research is based on a literature review that shows that objects produced by additive technologies do not always have consistent quality suitable for the given purpose of use. Besides, they have different effects on the environment and leave different footprints. The overall goal of the research was to find out the most suitable thermoplastic material for printing shield frames in terms of mechanical properties, geometric accuracy, weight, printing time, filament price, and environmental sustainability. Fused deposition modeling (FDM) technology was used for 3D printing, and three different filaments were investigated: polylactic acid (PLA), polyethylene terephthalate (PETG), and polyhydroxyalkanoate (PHA). The weighted sum method for multi-objective optimization was used. Finally, PHA material was chosen, mainly due to its environmental sustainability, as it has the most negligible impact on the environment.     

Application of 3D printing technology combined with PBL teaching model in teaching clinical nursing in congenital heart surgery: A case-control study

We aimed to explore the application of three-dimensional (3D) printing technology with problem-based learning (PBL) teaching model in clinical nursing education of congenital heart surgery, and to further improve the teaching quality of clinical nursing in congenital heart surgery. In this study, a total of 132 trainees of clinical nursing in congenital heart surgery from a grade-A tertiary hospital in 2019 were selected and randomly divided into 3D printing group or traditional group. The 3D printing group was taught with 3D printed heart models combined with PBL teaching technique, while the traditional group used conventional teaching aids combined with PBL technique for teaching. After the teaching process, the 2 groups of nursing students were assessed and surveyed separately to evaluate the results. Compared to the traditional group, the theoretical scores, clinical nursing thinking ability, self-evaluation for comprehensive ability, and teaching satisfaction from the questionnaires filled by the 3D printing group were all higher than the traditional group. The difference was found to be statistically significant (P < .05). Our study has shown the 3D printing technology combined with the PBL teaching technique in the clinical nursing teaching of congenital heart surgery achieved good results.     

One-stop procedure of “Atrial fibrillation radiofrequency ablation + left atrial appendage closure” guided by 3D printing technology: A case report

Left atrial appendage occlusion (LAAO) in the treatment of atrial fibrillation (AF) has become a hot topic in clinical research in recent years. We report a 68-year-old female with a 3-year history of paroxysmal atrial fibrillation refractory to antiarrhythmic therapy and unable to tolerate anticoagulation therapy who underwent successful atrial fibrillation radiofrequency ablation combined with left atrial appendage occlusion guided by 3D printing technology. There was no recurrence of her atrial fibrillation and there was continued complete occlusion of her left atrial appendage at 3-month and 1-year follow-ups.This case supports the potential advantage of 3D printing technology to guide a “one-stop combined AF radiofrequency ablation and left atrial appendage occlusion procedure.” But whether it can improve the prognosis and quality of life of patients, further multi-center research and large data statistics are required.