3D打印技术在“特殊分层”脑出血中的应用

【摘要】目的探讨三维重建数字设计及3D打印穿刺导板在一种“特殊分层”脑出血治疗中的应用。方法回顾性分析9例“特殊分层”脑出血患者的临床资料，所有患者进行术前血肿三维分析、设计手术方案及应用3D穿刺导板精准手术治疗，术后通过CT复查评价手术效果。结果所有患者通过术前应用三维软件分析血肿阈值、精准选择治疗方案、设计个性化应用3D打印穿刺导板进行手术治疗，达到了精准定位微创穿刺血肿；术后CT复查，血肿引流效果良好、患者症状明显减轻，达到了术前三维设计目的，进针方向与术前模拟一致、引流管位置位于血肿中心。所有患者无穿刺失败及穿刺通道出血。结论采用三维软件分析“特殊分层”血肿阈值、精准选择治疗方案、应用3D打印穿刺导板辅助“特殊分层”脑出血手术治疗，能达到精准、安全治疗，效果良好。

Abstract: Objective To explore the application of 3D digital design reconstruction and puncture guide printing in the treatment of “special stratification” cerebral hemorrhage. Methods The clinical data of 9 patients with “special stratification” intracerebral hemorrhage were analyzed retrospectively. All patients underwent 3D analysis of preoperative hematoma, designed surgical scheme and precise surgical treatment with 3D puncture guide plate. The surgical effect was evaluated by CT reexamination after operation. Results All patients achieved accurate positioning of minimally invasive puncture hematoma through preoperative application of 3D software to analyze hematoma threshold, accurately select treatment scheme, design individualized 3D printing puncture guide plate for surgical treatment. Postoperative CT reexamination showed that the drainage of hematoma was good, the symptoms of patients were significantly relieved, the purpose of preoperative 3D design was achieved, the direction of needle approaching was consistent with the preoperative simulation, and the position of drainage tube was located in the center of hematoma. All patients had no puncture failure and puncture channel bleeding. Conclusions Using 3D software to analyze the hematoma threshold of “special stratification”, accurately selecting the treatment scheme, applying 3D printing puncture guide plate to assist the surgical treatment of “special stratification” intracerebral hemorrhage can achieve accurate and safe treatment with good effect.