CAJ | 학술논문

目的利用数字化设计结合3D打印技术研制个体化导板,初步探讨其应用于肩关节周围穿刺的可行性. 方法选取需要行肩关节穿刺的9例患者(男4例,女5例;年龄39～62岁,平均56.8岁)的9侧关节(左侧3例,右侧6例;关节腔8例,肱骨近端1例)的薄层CT扫描数据在Mimics15.0软件中进行三维建模,把重建出来的模型导入Geomagic Studio和Geomagic Spark进行反求及正向设计,经3D打印技术制作出经皮导板,在体外模拟穿刺,明确进针方位后,对9例患者精准定位,穿刺活检,并采用C型臂X线机透视证实穿刺是否成功. 结果经过穿刺前在患者骨骼模型及穿刺术的验证,应用数字化个性3D打印定制经皮导板对9患者导向下穿刺全部成功,进针方位均与术前设计的虚拟方案一致,无穿刺失败,未出现血管、神经损伤症状. 结论数字化设计结合3D打印技术制作的个性定制经皮导板可以实现肩关节周围的精准穿刺.
목적 이용수자화설계결합3D타인기술연제개체화도판,초보탐토기응용우견관절주위천자적가행성. 방법 선취수요행견관절천자적9례환자(남4례,녀5례;년령39～62세,평균56.8세)적9측관절(좌측3례,우측6례;관절강8례,굉골근단1례)적박층CT소묘수거재Mimics15.0연건중진행삼유건모,파중건출래적모형도입Geomagic Studio화Geomagic Spark진행반구급정향설계,경3D타인기술제작출경피도판,재체외모의천자,명학진침방위후,대9례환자정준정위,천자활검,병채용C형비X선궤투시증실천자시부성공. 결과 경과천자전재환자골격모형급천자술적험증,응용수자화개성3D타인정제경피도판대9환자도향하천자전부성공,진침방위균여술전설계적허의방안일치,무천자실패,미출현혈관、신경손상증상. 결론 수자화설계결합3D타인기술제작적개성정제경피도판가이실현견관절주위적정준천자.
Objective To study the feasibility of using the customized guide plate manufactured by digital modeling and 3D printing technology in the periarticular puncture of the shoulder.Methods Nine patients with shoulder disorder were enrolled in this study.They were 4 males and 5 females,39 to 62 years of age (average,56.8 years).Four cases were from Shanghai Ninth People's Hospital between May 2014 and August 2014; 5 cases were from Guizhou Provincial People's Hospital between August 2014 and October 2014.Altogether 9 shoulders were involved (3 at the left side,6 at the right side; 8 joint cavities and one proximal humerus).Data of their lamellar CT scans were imported into Mimics15.0 for 3D anatomical modeling.We did reverse and sequential engineering throughout the software Geomagic Studio and Geomagic Spark.First the insertion points were determined after the in vitro simulated puncture in the customized percutaneous guide plate manufactured by digital modeling and 3D printing technology.Next the periarticular puncture of the shoulder was performed in the 9 patients after precise positioning and to be checked using C-arm fluoroscopy.Results In this study,the periarticular puncture of the shoulder was performed successfully in both the preoperative simulation in the skeleton model manufactured by digital modeling and 3D printing technology and the 9 patients.The positions of needling in the real operation were in total agreement with the preoperative virtual design.No puncture failure or side lesions of the vessels and nerves occurred.Conclusion The customized percutaneous guide plate manufactured by digital modeling and 3D printing technology can make the periarticular puncture of the shoulder more precise.