摘要
目的探讨复合性眼眶骨折的三维实体模型的构建方法和眼眶骨折修复重建手术的计算机辅助设计和辅助制造(CAD/CAM)。方法选择2003年8月至2004年3月在上海第九人民医院眼科就诊的12例复合性眼眶骨折患者,进行眼眶螺旋CT检查。首先将CT数据资料输入计算机进行三维实体建模,并通过自行开发的计算机辅助手术导航软件进行骨折骨块的移动、旋转及复位,记录骨块在各个轴位的移动量,为手术导航。其次计算眼眶容积,对比两侧眼眶容积的差异,为手术中所需植入材料的体积提供参考。最后制作快速原型,实际模拟手术。所有患者均施行眼眶重建眼球功能性复位手术,术后随访3～9个月,评估疗效。结果眼眶骨折修复重建手术的计算机辅助设计和制造系统整体运行良好,系统应用软件的功能达到设计要求,交互式操作方便实用,测量结果稳定可靠,实现了眼眶骨折手术的计算机辅助设计和制造。12例患者在手术后均达到满意的疗效:骨折眼眶复位良好,眼球内陷和下移得到矫正,复视和眼球运动受限明显改善,未发生视力下降或丧失。结论眼眶骨折修复重建手术的计算机辅助设计和制造系统能够为眼眶手术提供重要参考,提高手术疗效、降低风险。
Objective To reconstruct the three-dimensional （3 D） imaging and computer-generated models of the complex orbital fractures, and to develop a Computer-Aided Design / Computer-Aided Manufacture （CAD/CAM） system for orbital fracture repair. Methods We carried out study on 12 patients with orbital fractures from August 2003 to March 2004 in the Ninth People＇s Hospital. Before the orbital fracture repair, helical computer tomography scanning was applied to acquire the 3 D imaging data of the patient＇s orbits. The 3 D imaging data were then transferred to a CAD/CAM interactive program for image processing, which then designed and produced a stereolithography model mathematically. Using the designed software, the repair of orbital fractures could be planned with the computer. At the same time, the orbital cubage was calculated. Then the operation was performed and the effect of the therapy was evaluated. Results Using the CAD/CAM system of orbital fracture repair, the 3 D image of the orbit could be reconstructed, and the orbital cubage could be calculated accurately. The preoperative surgical plan was put into reality. After the orbital fracture repair, all cases received excellent appearance and function. This system had proved to run smoothly and accurately, and could easily be controlled. Conclusions The CAD/ CAM system of the orbital fracture repair may be proved as one of the most useful clinical tools for orbital surgery.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2005年第12期1092-1097,共6页
Chinese Journal of Ophthalmology
基金
上海市卫生系统百名跨世纪优秀学科带头人培养计划(98BR005)
上海市青年科技启明星后计划(00QNH1460)
关键词
外科手术
计算机辅助
骨折
修复外科手术
制造技术
Surgery,computer-assisted
Orbital fractures
Reconstructive surgical procedures
