【摘要】 目的探讨3D打印导板用于眼眶手术钛网预成形的可行性并观察其初步效果。方法选取2013年1月~2015年12月在河北医科大学第二医院眼科行眼眶骨折手术的患者20例20只眼,术前眼球内陷均大于3 mm。所有患者术前行螺旋CT扫描,将所得数据利用Mimics软件进行三维重建,然后通过计算机辅助设计方法对眶壁缺损区域进行镜像修复,应用软件布尔运算中的减运算,以镜像后的眶壁数据减去原有的缺损眶壁数据,从而得到与眶壁缺损区域吻合的修复体模型。使用3D打印机打印修复体模型,以修复体模型作为钛网修剪及成形的导板,行眶壁修复成形术。术后观察视力、眼球突出度、复视等情况以评价手术效果。结果手术的20例患者术后6个月时均无视力下降;有17例患者眼球突出度之差≤2 mm;13例术前合并复视的患者,11例术后6个月时复视消失。3D打印导板有助于钛网与眶壁缺损区域更为精确的吻合,并缩短了手术中用于钛网成形的时间。结论3D打印的个体化手术导板可较好的用于钛网的三维预成形,有利于提高手术精确性,并缩短手术时间。更多还原

【Abstract】 Objective To discuss the feasibility of 3D printing guide plate used for titanium mesh pre-forming in orbital surgery and observe its preliminary effect. Methods From January 2013 to December 2015, 20 patients(20 eyes)underwent orbital fracture surgery in the Second Hospital of Hebei Medical University were enrolled in the study. Preoperative eyeball invagination was greater than 3 mm. All the patients underwent spiral CT scan before operation. The data were reconstructed by Mimics software, and then the images were repaired by computer aided design. The subtraction operation in the Boolean operation of the software was applied, and the original defect orbital wall data were subtracted from the repaired image. 3D printing guide plate was used for titanium mesh pre-forming in orbital surgery. Visual acuity, exophthalmos and diplopia were observed after operation to evaluate the effect. Results No visual acuity was reduced at 6 months post surgery in the 20 patients, the difference of the protrusion of the eyes were equal to or less than 2 mm in 17 patients, diplopia disappeared in 11 patients at 6 months post operation. The 3D printing guide plate helped to achieve more precise anastomosis between titanium mesh and orbital defect area, and reduced the time required for titanium mesh formation in operation. Conclusion The individualized surgical guide plate can be used for3D pre-forming of titanium mesh, which is helpful to improve the accuracy of operation and reduce the operation time.更多还原