吉林大学学报(医学版) ›› 2023, Vol. 49 ›› Issue (5): 1351-1357.doi: 10.13481/j.1671-587X.20230532

• 临床医学 • 上一篇    

3D打印钛合金胸骨治疗传统钛板胸骨重建术失败患者1例报告及文献复习

刘帅1,商圣涛1,尹腾程1,薛锦儒1,刘曦宇1,侯奕楠2,王岩1()   

  1. 1.吉林大学中日联谊医院胸外科,吉林 长春 130033
    2.东北师范大学校医院电诊科,吉林 长春 130024
  • 收稿日期:2022-11-03 出版日期:2023-09-28 发布日期:2023-10-26
  • 通讯作者: 王岩 E-mail:wyan2009@jlu.edu.cn
  • 作者简介:刘 帅(1994-),男,吉林省吉林市人,在读硕士研究生,主要从事胸外科疾病诊治方面的研究。
  • 基金资助:
    吉林省科技厅科技发展计划项目(YDZJ202102CXJD073)

3D printed titanium alloy sternum in treatment of patients with failed conventional titanium plate sternal reconstruction: A case report and literature review

Shuai LIU1,Shengtao SHANG1,Tengcheng YIN1,Jinru XUE1,Xiyu LIU1,Yinan HOU2,Yan WANG1()   

  1. 1.Department of Thoracic Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China
    2.Department of Electrical Diagnosis,School Hospital,Northeast Normal University,Changchun 130024,China
  • Received:2022-11-03 Online:2023-09-28 Published:2023-10-26
  • Contact: Yan WANG E-mail:wyan2009@jlu.edu.cn

摘要:

目的 观察3D打印钛合金胸骨对于传统钛板胸骨重建术失败患者术后胸骨重建的治疗效果,为该类疾病的治疗提供依据。 方法 收集1例胸骨恶性肿瘤患者的临床资料,观察患者的手术过程,随访患者身体功能恢复情况,并结合相关文献进行总结和复习。 结果 患者,男性,59岁,因无明显诱因出现胸骨疼痛行胸部计算机断层扫描(CT)检查,提示胸骨占位性病变,以“胸骨肿物”收入院,2017年行胸骨部分切除术并置入传统钛板,术后1年患者肢体活动严重受限并出现钛板折断和变形,于2019年行3D打印钛合金胸骨植入修复胸骨缺损及胸廓重建术,术后患者肢体活动逐渐恢复,活动幅度由小到大,由被动活动过渡到主动活动,逐渐恢复肩关节的正常活动范围,肢体活动情况较术前改善较大,2020年因患者皮下脂肪较薄且纤维结缔组织已形成稳定连接,按计划行手术治疗将3D打印钛合金胸肋骨锁骨板取出,术后患者康复顺利,随访至今,双上肢活动正常,生活质量大幅度提升,预后良好。 结论 3D打印钛合金胸骨能实现精准个性化治疗,效果优于传统钛板胸骨,可保证患者人体解剖复位并减少并发症发生。

关键词: 胸骨恶性肿瘤, 3D打印胸骨, 胸骨重建, 功能修复, 随访

Abstract:

Objective To observe the therapeutic effect of 3D-printed titanium alloy sternum in the postoperative reconstruction of sternum in the patients with failed conventional titanium plate stermal reconstruction, and to provide the evidence for the treatment of such disease. Methods The clinical data of one patient with malignant sternum tumor were collected. The patient’s operation process was observed, and the recovery of the patient’s physical function was followed up. The relevant literatures were reviewed and summarized. Results One patient, a 59-year-old male, presented with sternum pain without obvious cause and received the chest computed tomography(CT) examination, which indicated a space-occupying lesion in the sternum. The patient was admitted with the diagnosis of “sternal tumor” and underwent partial sternectomy and conventional titanium plate placement in 2017. Subsequently, the patient experienced severe restriction of limb movement, titanium plate fracture, and deformation 1 year after operation. In 2019, 3D-printed titanium alloy sternum implantation was performed to repair the sternum defect and reconstruct the thoracic cage.Compared with before operation, the patient’s limb movement gradually recovered, ranging from passive to active activities, and the normal range of motion of the shoulder joint was gradually improved significantly after operation. In 2020, due to the thin subcutaneous fat and stable formation of fibrous connective tissue, the planned operation was performed to remove the 3D-printed titanium alloy sternal rib clavicle plate. The postoperative recovery of the patient was smooth, and the upper limb activity was normal and the quality of life was significantly improved.The prognosis was good. Conclusion The application of 3D-printed titanium alloy sternum enables precise personalized treatment, which is superior to the conventional titanium plate, and it can ensure the anatomical restoration and reduce the occurrence of complications in the patients.

Key words: Malignant neoplasm of sternum, 3D printed sternum, Sternal reconstruction, Functional repairment, Follow-up

中图分类号: 

  • R730.56