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  本文選題：3D打印技術 + 足踝骨折��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:利用3D打印技術重建患者數(shù)據(jù),通過3D打印機,獲得接近1:1病變部位的實物模型,將3D重建軟件及模型引入足踝骨折病例診治與教學,探討其應用價值。方法:病例分別選自我院40例足踝骨折患者的術前影像學資料,pilon骨折10例、踝周骨折18例、跟骨骨折12例,使用Mimics 14.0軟件三維重建,演示虛擬術中復位和打印3D模型。將在我院規(guī)培的臨床外科醫(yī)生及本科實習生共60名,隨機分為實驗組和對照組,各30人。實驗組采用3D打印技術結合傳統(tǒng)病例教學的模式,對照組采用傳統(tǒng)病例教學模式,以問卷調(diào)查及出科考試成績的形式評估兩組的教學效果;再分別挑選骨科副主任(專家組)8人和主治醫(yī)生9名(年輕組),分別單獨根據(jù)X線、CT三維重建和3D打印技術的影像學資料進行診斷,結合術中所見骨折情況,分別對17人的診斷正確率進行對比分析,得出結論。結果:1、兩組學生的教學成效問卷調(diào)查結果顯示實驗組在自評得分(課程評估、教學評價、掌握程度、自學能力、理解能力、學習效率、課程專注度)都高于對照組(P0.01);出科考核成績(理論知識、手術方案設計)顯示實驗組高于對照組(P0.01),均有統(tǒng)計學意義。2、使用X線、CT三維重建與3D打印技術對足踝骨折分類有統(tǒng)計學意義,對比診斷方法的準確率看,X線、CT三維重建及3D打印技術的正確率依次提高,3D打印技術比X線、普通CT重建更能清楚觀察骨折情況。結論:1、3D打印技術結合傳統(tǒng)教學方法應用于足踝病例教學,既可彌補傳統(tǒng)教學的欠缺,還能提高年輕醫(yī)師學習的積極性,降低學習難度,縮短學習曲線,具備良好的教學效果。2、3D打印技術可以讓臨床醫(yī)生任意角度、直接觀察骨折的立體解剖位置,獲取更全面的骨折立體圖形信息,提高診斷準確率。
[Abstract]:Objective: to reconstruct the patient's data by 3D printing technology and to obtain the object model near 1:1 by 3D printer, and to introduce 3D reconstruction software and model into the diagnosis, treatment and teaching of foot and ankle fracture, and to discuss its application value. Methods: the preoperative imaging data of 40 patients with foot and ankle fractures were selected from our hospital, including 10 cases of perimalleolar fractures, 18 cases of perimalleolar fractures and 12 cases of calcaneal fractures. The 3D reconstruction software Mimics 14.0 was used to demonstrate the reduction and printing of 3D models during virtual operation. A total of 60 clinical surgeons and undergraduate interns were randomly divided into experimental group and control group. The experimental group used 3D printing technology combined with the traditional case teaching model, the control group adopted the traditional case teaching model, the form of questionnaire survey and exam scores were used to evaluate the teaching effect of the two groups. Then the deputy director of orthopedic department (expert group 8 and attending doctor 9) (young group) were selected separately for diagnosis according to the imaging data of X-ray CT 3D reconstruction and 3D printing, respectively, and combined with the intraoperative fracture situation. The diagnostic accuracy of 17 patients was compared and analyzed, and the conclusion was drawn. Results the results of the questionnaire survey on the teaching effectiveness of the two groups of students showed that the experimental group had self-evaluation scores (curriculum evaluation, teaching evaluation, mastery, self-study ability, understanding ability, learning efficiency). The degree of course focus was higher than that of the control group (P 0.01). The design of operation plan) showed that the experimental group was higher than the control group (P 0.01), all had statistical significance. The classification of ankle fracture was statistically significant by using X-ray CT 3D reconstruction and 3D printing technology. Compared with the accuracy of the diagnostic methods, the accuracy of X-ray CT 3D reconstruction and 3D printing technology in turn increased than X-ray, ordinary CT reconstruction can clearly observe the fracture. Conclusion the application of 3 D printing technique combined with traditional teaching method in ankle case teaching can not only make up for the deficiency of traditional teaching, but also improve the enthusiasm of young doctors, reduce the learning difficulty and shorten the learning curve. The 3D printing technique with good teaching effect can make clinicians observe the stereoscopic anatomical position of fracture directly at any angle, obtain more comprehensive information of three-dimensional pattern of fracture, and improve the accuracy of diagnosis.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3;TP391.73

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