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

【摘要】：目的:利用3D打印技術(shù)重建患者數(shù)據(jù),通過(guò)3D打印機(jī),獲得接近1:1病變部位的實(shí)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(xué),探討其應(yīng)用價(jià)值。方法:病例分別選自我院40例足踝骨折患者的術(shù)前影像學(xué)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(shù)中復(fù)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(shí)習(xí)生共60名,隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,各30人。實(shí)驗(yàn)組采用3D打印技術(shù)結(jié)合傳統(tǒng)病例教學(xué)的模式,對(duì)照組采用傳統(tǒng)病例教學(xué)模式,以問(wèn)卷調(diào)查及出科考試成績(jī)的形式評(píng)估兩組的教學(xué)效果;再分別挑選骨科副主任(專(zhuān)家組)8人和主治醫(yī)生9名(年輕組),分別單獨(dú)根據(jù)X線、CT三維重建和3D打印技術(shù)的影像學(xué)資料進(jìn)行診斷,結(jié)合術(shù)中所見(jiàn)骨折情況,分別對(duì)17人的診斷正確率進(jìn)行對(duì)比分析,得出結(jié)論。結(jié)果:1、兩組學(xué)生的教學(xué)成效問(wèn)卷調(diào)查結(jié)果顯示實(shí)驗(yàn)組在自評(píng)得分(課程評(píng)估、教學(xué)評(píng)價(jià)、掌握程度、自學(xué)能力、理解能力、學(xué)習(xí)效率、課程專(zhuān)注度)都高于對(duì)照組(P0.01);出科考核成績(jī)(理論知識(shí)、手術(shù)方案設(shè)計(jì))顯示實(shí)驗(yàn)組高于對(duì)照組(P0.01),均有統(tǒng)計(jì)學(xué)意義。2、使用X線、CT三維重建與3D打印技術(shù)對(duì)足踝骨折分類(lèi)有統(tǒng)計(jì)學(xué)意義,對(duì)比診斷方法的準(zhǔn)確率看,X線、CT三維重建及3D打印技術(shù)的正確率依次提高,3D打印技術(shù)比X線、普通CT重建更能清楚觀察骨折情況。結(jié)論:1、3D打印技術(shù)結(jié)合傳統(tǒng)教學(xué)方法應(yīng)用于足踝病例教學(xué),既可彌補(bǔ)傳統(tǒng)教學(xué)的欠缺,還能提高年輕醫(yī)師學(xué)習(xí)的積極性,降低學(xué)習(xí)難度,縮短學(xué)習(xí)曲線,具備良好的教學(xué)效果。2、3D打印技術(shù)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(zhǔn)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(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3;TP391.73

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