3D打印技術(shù)在復(fù)雜關(guān)節(jié)周圍骨折臨床帶教中的應(yīng)用

蒙德鵬 陳宇 林浩東

摘 要：目的 將3D打印教具應(yīng)用于骨創(chuàng)傷科復(fù)雜關(guān)節(jié)周圍骨折的臨床教學(xué)中，探索該方法的教學(xué)效果。方法 隨機(jī)抽取60名在長(zhǎng)征醫(yī)院骨創(chuàng)傷科輪轉(zhuǎn)的上海住院醫(yī)師規(guī)范化培訓(xùn)學(xué)員進(jìn)入研究，隨機(jī)分為試驗(yàn)組和對(duì)照組，每組30人。挑選典型的股骨髁、脛骨平臺(tái)骨折病例，使用CT斷層掃描，數(shù)字成像及3D打印技術(shù)制成3D樹脂標(biāo)本。對(duì)照組采用單純常規(guī)教學(xué)法，試驗(yàn)組在此基礎(chǔ)上結(jié)合3D打印標(biāo)本進(jìn)行臨床帶教。比較兩組學(xué)員的基本資料和出科考試成績(jī)。結(jié)果 兩組學(xué)員經(jīng)管患者數(shù)量、經(jīng)管關(guān)節(jié)骨折患者數(shù)量和教學(xué)滿意度評(píng)分比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。試驗(yàn)組出科理論考核成績(jī)?yōu)椋?2.14±13.25）分，高于對(duì)照組的（64.47±11.12）分，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 3D打印技術(shù)對(duì)復(fù)雜關(guān)節(jié)周圍骨折教學(xué)效果有輔助促進(jìn)作用，具有良好的教學(xué)應(yīng)用前景。

關(guān)鍵詞：三維；打印；教學(xué)；創(chuàng)傷

中圖分類號(hào)：R683 文獻(xiàn)標(biāo)識(shí)碼：B DOI：10.3969/j.issn.1006-1959.2018.23.008

文章編號(hào)：1006-1959（2018）23-0026-03

Abstract：Objective The 3D printing teaching aid was applied to the clinical teaching of complex periarticular fractures in the trauma department of bone trauma， and the teaching effect of the method was explored.Methods 60 standardized training trainees of Shanghai resident physicians in bone trauma rotation in changzheng hospital were randomly selected to enter the study. They were randomly divided into experimental group and control group， 30 in each group. Typical cases of femoral condyle and tibial plateau fractures were selected and 3D resin specimens were prepared by CT tomography， digital imaging and 3D printing. The control group adopted the simple conventional teaching method， and the experimental group conducted clinical teaching combined with 3D printed specimens on this basis. To compare the basic data and test scores of the two groups. Results There was no statistically significant difference between the two groups in the number of patients with menstrual canal， the number of patients with menstrual canal joint fracture and the teaching satisfaction score （P>0.05）. The theoretical assessment score of the test group was （82.14±13.25）， higher than that of the control group （64.47±11.12），the difference was statistically significant （P<0.05）. Conclusion 3D printing technology can assist and promote the teaching effect of complex periarticular fractures and has a good prospect of teaching and application.

Key words：Three-dimensional；Printing；Teaching；Trauma

3D打印概念最開始由Charles Hull在上世紀(jì)80年代提出并發(fā)明了相關(guān)技術(shù)，屬快速成形技術(shù)的一種，是通過層層沉淀制作物件[1]。隨著技術(shù)的進(jìn)展，目前已實(shí)現(xiàn)3D物件的高精度、低成本、快速制作及在生物醫(yī)學(xué)領(lǐng)域的發(fā)展[2-4]。除了可用于輔助手術(shù)策略、內(nèi)植物制作及組織工程，3D打印另一個(gè)重要的醫(yī)學(xué)應(yīng)用是進(jìn)行醫(yī)學(xué)教育[5，6]。隨著交通及經(jīng)濟(jì)的高速發(fā)展，高能量損傷導(dǎo)致的復(fù)雜骨折越來(lái)越常見。骨創(chuàng)傷是骨科的基礎(chǔ)學(xué)科，骨折致傷機(jī)制復(fù)雜，骨折類型多變。復(fù)雜關(guān)節(jié)周圍骨折相關(guān)內(nèi)容的講授一直是骨創(chuàng)科臨床帶教的難點(diǎn)[7]。本研究擬將3D打印教具應(yīng)用于骨創(chuàng)傷科復(fù)雜關(guān)節(jié)周圍骨折的臨床教學(xué)中，探索該方法的教學(xué)效果。