术前应用CT辅助下3D打印技术模拟复杂骨盆骨折的价值研究

目的探讨术前应用CT辅助下3D打印技术模拟复杂骨盆骨折的价值。方法选取2017年5月至2018年3月我院收治的骨盆骨折患者45例作为3D打印组,采用激光快速自动成型机快速制作骨盆骨折个体化标本,标本需囊括解剖动、静脉血管,临床医生根据3D模型个体化标本情况,讨论最终方案。另选择同时期45例骨盆骨折患者作为常规组,常规组手术前仅进行X线、CT检查。比较两组患者手术效果、手术时间、术中出血量、输血量及围手术期并发症。结果两组患者手术时间、术中出血量、输血量比较存在明显差异,3D打印组患者手术时间、术中出血量、输血量明显低于常规组(P<0.001);常规组患者优良率为95.55%(43/45),3D打印组优良率为82.22%(37/45),3D打印组优良率显著高于常规组,差异有统计学意义(P<0.05);两组患者均为出现明显并发症,常规组患者出现1例(2.22%)切口感染、1例(2.22%)下肢静脉血栓,3D打印组出现1例(2.22%)切口感染,两组患者围手术期并发症发生率比较无明显差异(P>0.05)。结论复杂骨盆骨折术前应用CT辅助下3D打印技术可直观了解骨折实际情况,手术前模拟手术方案更有利于优化手术效果。

Value of CT-assisted 3D Printing in the Simulation of Complex Pelvic Fracture before Operation

Objective To evaluate the value of CT-assisted 3 D printing technique in simulating complex pelvic fractures before operation. Methods 45 patients with pelvic fracture treated in our hospital from May 2017 to March 2018 were selected as the threedimensional printing group. Individualized specimens of pelvic fracture were made by laser rapid prototyping machine. The specimens should include anatomical arteries and veins. Clinicians discuss the final plan according to the individual specimens of the 3 D model. Another 45 patients with pelvic fracture at the same time were selected as the routine group, and only X-ray and CT examinations were performed before operation in the routine group. The operation effect, operation time, intraoperative bleeding volume, blood transfusion volume and perioperative complications were compared between the two groups. Results There were significant differences in operation time, intraoperative blood loss and blood transfusion between the two groups. The operation time, intraoperative blood loss and blood transfusion in the 3 D printing group were significantly lower than those in the conventional group(P<0.001). The excellent and good rate was 95.55%(43/45) in the conventional group and 82.22%(37/45) in the 3 D printing group. The excellent and good rate in the 3 D printing group was significantly higher than that in the conventional group(P<0.05). There were obvious complications in both groups. There were 1 case(2.22%) of incision infection, 1 case(2.22%) of lower extremity venous thrombosis in conventional group and 1 case(2.22%) of incision infection in 3 D printing group. There was no significant difference in the incidence of perioperative complications between the two groups(P>0.05). Conclusion CT-assisted 3-D printing technology can directly understand the actual situation of complex pelvic fractures before operation. Preoperative simulation of the operation program is more conducive to optimizing the operation effect.