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目的探讨3D打印技术制备的个体化模型及导板在骨肿瘤外科中的应用效果。方法 2015年10月—2016年12月,将3D打印技术制备的个体化模型及导板用于术前制定手术方案及术中治疗5例骨肿瘤患者。患者均为男性;年龄9~58岁,中位年龄32岁。其中左侧骨盆、股骨近端囊型包虫病合并股骨近端病理性骨折1例,左髂骨骨母细胞瘤合并动脉瘤样骨囊肿1例,左股骨纤维结构不良(牧羊拐畸形)合并病理性骨折1例,右跟骨转移癌1例(分期T2N0M0),左股骨中段尤文肉瘤1例(分期T2N0M0)。病程1个月~10年,平均2.25年。结果手术均顺利完成。手术时间2.6~7.5 h,平均4.9 h;术中出血量200~2 500 m L,平均1 380 m L;术中透视次数1~6次,平均3.8次。术后切口无感染,血运及神经功能良好。5例患者均获随访,随访时间3~16个月,平均5.4个月。内固定物无松动或断裂发生。术后3个月肢体功能评分采用Enneking评分系统,为15~26分,平均21分;获优2例、良2例、中1例。结论 3D打印技术用于骨肿瘤外科能更好地实现术前规划及评估,为骨肿瘤患者的个体化治疗提供了新方法。
Objective To explore the individualized models prepared by 3D printing technology and the application effects of guide plates in bone tumor surgery. Methods From October 2015 to December 2016, individualized models and guide plates prepared with 3D printing technology were used for the preoperative planning and surgical treatment of 5 patients with bone tumors. All patients were male; aged 9 to 58 years, median age 32 years. Among them, the left pelvis, proximal femoral cysticercosis with proximal femoral pathological fracture in 1 case, left tibial osteoblastoma with aneurysmal bone cyst in 1 case, left femur with poor fibrous structure (goat sheep deformity) merger There was one case of pathological fracture, one case of right calcaneal metastasis (stage T2N0M0), and one case of Ewing’s sarcoma in the middle of the left femur (stage T2N0M0). The disease duration ranged from 1 month to 10 years with an average of 2.25 years. The results were successfully completed. The operation time was 2.6-7.5 h with an average of 4.9 h. The intraoperative blood loss was 200-2 500 m L with an average of 1 380 m L. The intraoperative fluoroscopy frequency was 1-6 times with an average of 3.8 times. No incision after infection, blood supply and nerve function. All 5 patients were followed up for 3 to 16 months with an average of 5.4 months. No loosening or breakage of the internal fixation occurred. The Enneking score system was used for 3 months postoperatively and was scored from 15 to 26 points with an average of 21 points. There were 2 excellent, 2 good, and 1 good cases. Conclusion 3D printing technology for bone tumor surgery can better achieve preoperative planning and assessment, and provide a new method for individual treatment of bone tumor patients.