探讨3D打印技术在硬膜外血肿手术中的初步应用。

选取山东省滨州市阳信县人民医院神经外科自2016年1月至9月收治的2例硬膜外血肿患者，获取颅脑CT扫描的原始数据，制作硬膜外血肿的三维模型和与头面部组织完全贴合的"盔甲"三维模型，依据硬膜外血肿在"盔甲"模型的投影进行剪切，得到硬膜外血肿的范围，通过3D打印实体化得到手术模具。设计合理的手术切口进行手术，观察术后治疗效果。

患者术后复查CT显示血肿清除比较彻底，无迟发性出血；术前剧烈头痛、意识障碍及肢体偏瘫等颅内高压症状消失。随访6个月，患者恢复正常生活及社交，GOS评分5分。

应用3D打印技术进行模具打印，能够对硬膜外血肿进行精确定位，评估手术风险，选取合理的手术入路，降低手术创伤，解除血肿压迫。

To explore the preliminary application of three-dimensional (3D) printing technique in the operation of epidural hematoma.

Two cases of epidural hematoma in the Department of Neurosurgery, Yangxin County People’s Hospital of Binzhou City from January to September 2016 were selected to obtain the original data of brain CT scan. The three-dimensional model of epidural hematoma and the three-dimensional model of "armor" completely fitted to the head and facial tissues were made through Mimics 17.0 software. According to the projection of the epidural hematoma in the "armor" model, the scope of epidural hematoma is obtained, and the operative mold is obtained by 3D printing. The rational surgical incision was designed and the operation was performed. The effect of postoperative treatment was observed.

The operation has proved that the location of the epidural hematoma is accurate according to this method. After reexamination of CT hematoma, the removal of hematoma was more thorough and no delayed hemorrhage. The symptoms such as severe headache, disturbance of consciousness and hemiplegia before operation disappeared. After 6 months’ follow-up, the patients returned to normal life and social interaction, and the GOS score was 5 points.

For patients with epidural hematoma, the 3D printing technique was used before the operation, the accurate location of the epidural hematoma, the risk of operation, the rational surgical approach, the reduction of surgical trauma and the oppression of hematoma were selected. It is suitable for promotion in primary hospitals and junior doctors.