季卫平 王波 何世杰范秋平 沈继全 陈金堂 沈慧芸 潘剑飞

    [摘要] 目的 探討3D打印金属补块和髋臼杯在人工髋翻修中的应用价值。 方法 将2017年1月至2018年10月在丽水市人民医院需进行人工髋翻修的47例患者48侧髋纳入本研究。根据患者意愿及髋臼情况，将其分为实验组(3D打印钛)23例24髋和对照组(经典臼杯)24例，观察两组手术一般情况、视觉模拟评分(VAS)、临床功能评价及髋臼外展角。 结果 两组手术时间，术中失血和住院时间比较，差异无统计学意义(P>0.05);术后两组Harris评分、VAS评分及髋臼外展角均得到了不同程度的改善;实验组术后3、6及12个月Harris评分显著高于对照组;实验组术后7 d及术后3个月的VAS评分显著低于对照组(P0.05);术后3个月，实验组髋臼外展角明显大于对照组(P0.05). Harris score， VAS score and acetabular abduction angle were improved in different degrees in both groups after operation. Harris score in the experimental group was significantly higher than that in the control group at 3， 6 and 12 months after operation. The VAS scores of the experimental group were significantly lower than those of the control group at 7 days and 3 months after operation(P0.05). Three months after operation， the abduction angle of acetabulum in the experimental group was significantly greater than that in the control group(P0.05)，具有可比性。

    1.2 方法

    1.2.1 材料设计? 3D钛合金骨小梁金属臼杯全髋系统，由国内有资质的3D打印公司提供。手术者将超薄层CT扫描骨盆图像(我院为320排，0.625 mm)传给公司设计部门，公司根据高分辨高清图片进行骨骼模型3D打印，再根据模型设计臼杯大小和补块形状、大小;给术者寄回手术策划输出表 ......