曾芳俊　方世兵

[摘要] 目的 探討3D打印导板在髋臼肿瘤周围截骨假体重建术中的应用效果。 方法 将2010年10月～2017年10月我院接诊的18例髋臼肿瘤患者纳入本研究。按照是否使用3D打印导板将患者分为观察组10例和对照组8例，两组患者均接受髋臼肿瘤周围截骨假体重建术治疗，观察组患者术中使用3D打印导板，比较两组患者手术情况、术后髋关节X线测量结果、术后并发症情况以及随访6个月国际肌肉骨骼肿瘤学会评分标准（MSTS）评分。 结果 观察组患者手术时间、假体安装时间以及术中出血量均显著低于对照组（P<0.05）；观察组患者术后双下肢不等长距离、患侧旋转中心距正中线距离与健侧差值、患侧髋臼外展角与健侧差值、患侧髋臼前倾角与健侧差值均显著低于对照组，随访6个月MSTS评分显著高于对照组（P<0.05）；两组患者术后并发症总发生率无统计学差异（P>0.05）。 结论 髋臼肿瘤周围截骨假体重建术中使用3D打印导板能够提高手术效率、提高假体重建效果，值得临床推荐。

[关键词] 髋臼肿瘤；周围截骨假体重建术；3D打印导板；髋臼外展角

[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2018）23-0036-03

Application of 3D printing guide plate in prosthesis reconstruction of periacetabular osteotomy for acetabular neoplasms

ZENG Fangjun FANG Shibing

Department of Spine Surgery， Ganzhou People's Hospital in Jiangxi Province，Ganzhou 341000，China

[Abstract] Objective To investigate the application effect of 3D printing guide plate in prosthesis reconstruction of periacetabular osteotomy for acetabular neoplasms. Methods 18 patients with acetabular tumors admitted in our hospital from October 2010 to October 2017 were included in the study. The patients were divided into observation group（n=10） and control group（n=8） according to whether or not to use 3D printing guide plate. Both groups were treated with prosthesis reconstruction of periacetabular osteotomy. The observation group was given 3D printing guide plates during the operation. The patient's surgical condition， postoperative X-ray measurement of the hip， postoperative complications， and international musculo-skeletal tumor society （MSTS） score within 6-month follow-up between the two groups were compared. Results The operative time， prosthesis installation time， and blood loss during the operation in the observation group were significantly lower than those in the control group（P<0.05）. The unequal lengths of lower limbs after operation， the difference between the affected side and the healthy side in distance from rotation center to median line，the acetabular abduction angle difference between the affected side and the healthy side， acetabular acetabular angle difference the affected side and healthy side were significantly lower than those in the control group. The MSTS score in the observation group was significantly higher than in the control group in the follow-up 6 months（P<0.05）. The total incidence of postoperative complications in both groups was not statistically different（P>0.05）. Conclusion The use of 3D printing guide plate in prosthesis reconstruction of periacetabular osteotomy in acetabular neoplasms can improve the efficiency of surgery and improve the reconstruction effect of the prosthesis， which is worthy of clinical recommendation.

[Key words] Acetabular neoplasms； Prosthesis reconstruction of periacetabular osteotomy； 3D printing guide plate； Acetabular abduction angle

髋臼肿瘤是骨骼肿瘤的一种，手术切除并进行假体重建是治疗该病的主要手段，而且通过手术切除可以保留患者肢体功能[1]。临床研究表明，髋臼肿瘤切除后骨盆重建难度较高、假体安装精确度差等问题严重影响预后效果[2]。随着3D打印技术在骨科手术中的逐渐应用，利用3D打印模型和导板能够有效帮助医师定位解剖结构、明确骨盆结构间的空间位置，便于手术实施。但目前国内对于3D打印导板在髋臼肿瘤周围截骨假体重建术中的应用鲜有报道[4]。我院即在髋臼肿瘤手术中开展了3D打印的应用研究，以期为该技术的推广提供参考，现报道如下。……