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3D打印建模技术在脊髓性肌萎缩症脊柱侧弯超声引导穿刺手术模拟教学中的应用

Utilization of 3D printing modeling techniques in the simulation instruction of ultrasound-guided puncture procedures on scoliotic spines of spinal muscular atrophy.

作者信息

Xia Di, Xing Fangliang, Zhang Jiao, Lang Jiaxin, Tan Gang, Cui Xulei

机构信息

Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.

Beijing Intelligent Entropy Science & Technology Co Ltd, Beijing, China.

出版信息

3D Print Med. 2025 Apr 27;11(1):19. doi: 10.1186/s41205-025-00266-x.

Abstract

BACKGROUND

Puncture training with simulation models has emerged as a critical method for transmitting puncture skills, improving success rates, and minimizing injuries. Yet, obstacles such as proper material for ultrasound guidance, restricted options of 3D printing resources, and available substances to simulate human skin and muscle still hinder the production of simulation models that closely replicate clinical practice. This study aimed to develop a selective laser melting (SLM), 3D-printed simulation model that replicated the spine and skin contours of patients with spinal scoliosis.

METHODS

The 3D models of the scoliotic spines were developed from 3D reconstructions of high-resolution, computed tomography images from patients with spinal scoliosis, while the models of the skin to the bone structure were constructed based on the 3D reconstructions of the skin contours. SLM technology was used to print 3D models of the patients' spines. Gelatin casting was implemented to simulate the patients' skin and muscle tissues and to meet ultrasound anatomical requirements. Practical puncture training, which closely resembles clinical puncture practice, was then carried out to validate the effectiveness of the model. Improvements in proficiency and confidence in performing ultrasound-guided punctures after the simulation-model training were evaluated using the paired sample t test.

RESULTS

This research utilized 3D digital modeling, SLM 3D printing technology, and gelatin casting to establish simulation models of patients' spines and skin contours impacted by spinal scoliosis. The use of medical grade stainless steel material for modeling the spine and gelatin for skin and muscle tissues ensured the model had superior ultrasound anatomical properties. After the simulation training session, participants' proficiency and confidence in both ultrasound-assisted positioning and real-time guided puncture showed significant improvement, demonstrating the effectiveness of the simulation training model.

CONCLUSIONS

The simulation model closely mimicked real clinical situations and was an effective training tool for medical professionals. Furthermore, these findings demonstrated the potential of 3D printing technology in developing simulation models that closely replicate real-world clinical scenarios and may have significant implications for medical education and training.

摘要

背景

使用模拟模型进行穿刺训练已成为传授穿刺技能、提高成功率和减少损伤的关键方法。然而,诸如用于超声引导的合适材料、3D打印资源选择受限以及模拟人体皮肤和肌肉的可用物质等障碍,仍然阻碍着能够紧密复制临床实践的模拟模型的制作。本研究旨在开发一种通过选择性激光熔化(SLM)3D打印的模拟模型,该模型能复制脊柱侧弯患者的脊柱和皮肤轮廓。

方法

脊柱侧弯脊柱的3D模型由脊柱侧弯患者的高分辨率计算机断层扫描图像的3D重建生成,而皮肤到骨骼结构的模型则基于皮肤轮廓的3D重建构建。使用SLM技术打印患者脊柱的3D模型。采用明胶浇铸来模拟患者的皮肤和肌肉组织,并满足超声解剖要求。然后进行与临床穿刺实践非常相似的实际穿刺训练,以验证模型的有效性。使用配对样本t检验评估模拟模型训练后在进行超声引导穿刺时熟练程度和信心的提高情况。

结果

本研究利用3D数字建模、SLM 3D打印技术和明胶浇铸,建立了受脊柱侧弯影响的患者脊柱和皮肤轮廓的模拟模型。使用医用级不锈钢材料对脊柱进行建模,以及使用明胶模拟皮肤和肌肉组织,确保了模型具有优异的超声解剖特性。模拟训练课程结束后,参与者在超声辅助定位和实时引导穿刺方面的熟练程度和信心均有显著提高,证明了模拟训练模型的有效性。

结论

该模拟模型紧密模拟了真实临床情况,是医疗专业人员的有效训练工具。此外,这些发现证明了3D打印技术在开发紧密复制现实世界临床场景的模拟模型方面的潜力,可能对医学教育和培训具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cc3/12034200/c74c36ae7d29/41205_2025_266_Fig1_HTML.jpg

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