Shi Z J, Zhang H, Jiang D H, Chen S F, Zhou L W, Tan G W, Wang Z X
Department of Neurosurgery, the First Affiliated Hospital of Xiamen University, Xiamen 361000, China.
Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou 221000, China.
Zhonghua Yi Xue Za Zhi. 2022 Jun 21;102(23):1766-1770. doi: 10.3760/cma.j.cn112137-20211019-02314.
To explore the application value of personalized three-dimensional (3D) printed protective cap in brain protection after decompressive craniectomy (DC). Fourty-five patients who underwent DC from January 2021 to October 2021 were selected, including 26 males and 19 females, aged 5-73 (50±13) years old. The brain CT data were imported into 3D Slicer software to rebuild the protective cap through 3D printing. The cap was worn on the head of the patient, thereby preventing secondary braindamage. The follow-up results were compared with 53 patients without protective capduring the same period. There were no statistically significant differences in age, skull defect location and follow-up time between the two groups (all >0.05).Among 45 patients, 47 brain protective caps (2 cases with bilateral skull defects) were successfully designed. The time for image post-processingand 3D printing was (21.2±6.0) min and (62.4±8.3) min, respectively. There were 6 cases of low compliance, 9 cases of moderate compliance, 32 cases of high compliance, respectively. Six cases with low conformity were redesigned and printed, 2 of 9 cases with moderate conformity were redesigned and printed, and the remaining 7 cases reached high compliance after grinding and packaging. In the current study, 45 patients with brain protective caps were followed up for 3 months, and no secondary brain injury occurred. However, among 53 patients without brain protective caps during the same period, 4 patients had secondary accidental brain compression. The incidence of injury was 7.5 %, and the difference was statistically significant (<0.001). Brain protective cap designed based on cranial CT and 3D printing can be used in patients with skull defects to protect the brain tissue from secondary crush damage and has certain clinical value.
探讨个性化三维（3D）打印保护帽在去骨瓣减压术（DC）后脑保护中的应用价值。选取2021年1月至2021年10月行DC的45例患者，其中男性26例，女性19例，年龄5 - 73（50±13）岁。将脑部CT数据导入3D Slicer软件，通过3D打印重建保护帽。将保护帽戴在患者头上，从而预防继发性脑损伤。将随访结果与同期53例未佩戴保护帽的患者进行比较。两组患者在年龄、颅骨缺损部位及随访时间方面差异均无统计学意义（均>0.05）。45例患者中，成功设计了47个脑保护帽（2例为双侧颅骨缺损）。图像后处理和3D打印时间分别为（21.2±6.0）分钟和（62.4±8.3）分钟。依从性低的有6例，中等的有9例，高的有32例。对6例依从性低的进行重新设计和打印，9例中等依从性的中有2例重新设计和打印，其余7例经打磨和包装后达到高依从性。本研究中，45例佩戴脑保护帽的患者随访3个月，未发生继发性脑损伤。然而，同期53例未佩戴脑保护帽的患者中，有4例发生继发性意外脑受压。损伤发生率为7.5%，差异有统计学意义（<0.001）。基于头颅CT和3D打印设计的脑保护帽可用于颅骨缺损患者，保护脑组织免受继发性挤压损伤，具有一定临床价值。
