發(fā)布時(shí)間：2018-11-21 20:20

【摘要】：[目的]探討3D打印四肢關(guān)節(jié)腫瘤假體在四肢大關(guān)節(jié)腫瘤手術(shù)治療中的新方法。[方法]2014年1月~2016年5月在本院接受治療的四肢關(guān)節(jié)骨腫瘤患者共6例,全部患者術(shù)前都對(duì)興趣區(qū)域行CT掃描(層厚為1.0mm),獲得平面圖像信息,再通過(guò)三維重建,得到DICOM格式數(shù)據(jù),將數(shù)據(jù)導(dǎo)入Mimics 17.0軟件中,編輯三維立體模型,在模型上確定截骨部位,并設(shè)計(jì)與剩余骨組織匹配的內(nèi)置物假體,包括鈦合金假體的孔徑、密度及孔隙度,新的韌帶附麗點(diǎn)。隨訪時(shí)利用國(guó)際骨骼肌肉腫瘤保肢(MSTS)功能評(píng)分系統(tǒng)對(duì)患者的預(yù)后進(jìn)行評(píng)估。[結(jié)果]所有患者都獲得隨訪,隨訪時(shí)間4~25個(gè)月,平均13.2個(gè)月,術(shù)后經(jīng)X線片證實(shí)剩余骨組織與腫瘤型假體匹配良好,未見假體松動(dòng)及骨溶解,未見腫瘤復(fù)發(fā)及轉(zhuǎn)移,6例患者仍存活,各關(guān)節(jié)功能恢復(fù)良好,最后一次隨訪時(shí)MSTS得分為17~28分,平均25.7分,其中優(yōu)3例,良2例,可1例,優(yōu)良率達(dá)83.3%。[結(jié)論]通過(guò)3D打印技術(shù)的應(yīng)用,可確定精確截骨范圍,設(shè)計(jì)個(gè)體化關(guān)節(jié)假體,調(diào)整鈦合金假體的孔徑、密度及孔隙度,在假體上設(shè)計(jì)個(gè)體化韌帶附麗點(diǎn),使之接近正常生理解剖,術(shù)后關(guān)節(jié)功能良好,為治療四肢關(guān)節(jié)骨腫瘤提供了一種新的方法。
[Abstract]:Objective: to explore a new method of 3D printing prosthesis for large joint tumor of extremities. [methods] from January 2014 to May 2016, 6 patients with bone tumors of extremities were treated in our hospital. All the patients underwent CT scanning (1.0mm) before operation. The DICOM format data were obtained, the data were imported into Mimics 17.0 software, the three-dimensional model was edited, the osteotomy position was determined on the model, and the pore size, density and porosity of the implant, including titanium alloy prosthesis, were designed to match the remaining bone tissue. The new ligaments are more beautiful. The prognosis of the patients was evaluated by using the international skeletal muscle tumor limb salvage (MSTS) score system during follow-up. [results] all the patients were followed up for 4 ~ 25 months with an average of 13.2 months. X-ray examination showed that the residual bone tissue matched well with the tumor prosthesis, no loosening and osteolysis of the prosthesis, no recurrence or metastasis of the tumor. At the last follow-up, the MSTS score was 17 ~ 28, with an average of 25.7, of which 3 were excellent, 2 were good and 1 was fair. The excellent and good rate was 83.3%. [conclusion] through the application of 3D printing technology, the precise osteotomy range can be determined, the individualized joint prosthesis can be designed, the aperture, density and porosity of titanium alloy prosthesis can be adjusted, and the individualized ligament attachment point can be designed on the prosthesis. It provides a new method for the treatment of bone tumors in extremities.
【作者單位】： 北華大學(xué)附屬醫(yī)院骨外科二療區(qū);
【分類號(hào)】：R738;TP391.73

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃志凌;;四肢關(guān)節(jié)骨折螺旋CT多平面重建運(yùn)用及臨床意義[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2008年31期

2 刁慶勛;金本杰;;24例火器性四肢關(guān)節(jié)穿透?jìng)某跗谔幚韀J];人民軍醫(yī);1986年12期

3 呂宏學(xué);宋軍峰;;四肢關(guān)節(jié)周圍骨折后的功能康復(fù)[J];中國(guó)療養(yǎng)醫(yī)學(xué);2009年09期

4 李克功;曲龍;杜朝暉;魏志宇;羅京生;劉勇;郭洪斌;郭偉;;應(yīng)用可吸收釘治療四肢關(guān)節(jié)周圍骨折療效觀察[J];中國(guó)現(xiàn)代醫(yī)藥雜志;2007年02期

5 馬劍平;畏寒發(fā)熱四肢關(guān)節(jié)u嗤碵J];江蘇醫(yī)藥;1980年01期

6 曹素霞;;個(gè)體化康復(fù)運(yùn)動(dòng)對(duì)四肢關(guān)節(jié)周圍骨折術(shù)后功能恢復(fù)的影響調(diào)查研究[J];中國(guó)民康醫(yī)學(xué);2014年04期

7 張振宇;王偉;;專用四肢關(guān)節(jié)低場(chǎng)MRI在踝部損傷中的應(yīng)用[J];軍事醫(yī)學(xué);2011年02期

8 劉躍會(huì),李英平,劉寶山;AO技術(shù)治療四肢關(guān)節(jié)骨折體會(huì)[J];承德醫(yī)學(xué)院學(xué)報(bào);2001年04期

9 趙海賓;郭巖峰;;CT檢查在四肢關(guān)節(jié)骨折診斷中的應(yīng)用[J];中國(guó)地方病防治雜志;2014年S2期

10 關(guān)建中;謝立旗;陳q，

本文編號(hào)：2348168