上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

数字化正颌外科流程及临床效果回顾性分析

代杰文， 王璧霞*， 魏弘朴， 李彪， 沈舜尧， 房兵， 沈国芳， 王旭东   

  1. 上海交通大学  医学院附属第九人民医院 口腔颅颌面科, 上海市口腔医学研究所, 上海 200011
  • 出版日期:2016-09-28 发布日期:2016-10-31
  • 通讯作者: 王旭东， 电子信箱： xudongwang70@hotmail.com。
  • 作者简介:代杰文（1980—）， 男， 主治医师， 博士； 电子信箱： daijiewen@163.com。 王璧霞（1987—）， 女， 护师， 本科； 电子信箱： bixia1987@hotmail.com。 *并列第一作者。
  • 基金资助:

    上海市教育委员会高峰高原学科建设计划(20152225); 上海交通大学医学院本科教学改革项目; 上海交通大学医学院医学教育研究项目(YB150619)

Retrospective analysis of the procedure of digital orthognathic surgery and its clinical effects

DAI Jie-wen, WANG Bi-xia*, WEI Hong-pu， LI Biao， SHEN Shun-yao， FANG Bin， SHEN Guo-fang, WANG Xu-dong   

  1. Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Online:2016-09-28 Published:2016-10-31
  • Supported by:

    Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support, 20152225; Undergraduate Teaching Reform Project of Shanghai Jiao Tong University School of Medicine; Medical Education Research Project of Shanghai Jiao Tong University School of Medicine, YB150619

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摘要：

目的·建立规范的数字化正颌外科流程并评价其效果。方法·选择2014—2015年接受数字化正颌外科治疗的788例牙颌面畸形患者作为研究对象，按照“临床资料收集、数据处理、计算机辅助手术规划与模拟、三维打印与合板处理、正颌外科手术实施、手术效果反馈与资料回收、多方核查与记录”的流程实施治疗并评价其效果。结果·所有788例患者获得了良好的手术效果，患者术前、术中和术后随访资料以及手术医生的评价和反馈信息得到了完整保存。未发生板丢失、混淆等重大失误。医生、管理护士和设计人员在整个流程中能流畅配合，对流程安排满意。在流程中出现的设计医生忘记调试板、板未及时消毒等情况，均在多方核查时及时发现和处理。结论·规范化的数字化正颌外科流程应包括临床资料收集、数据处理、计算机辅助手术规划与模拟、三维打印与板处理、正颌外科手术实施、手术效果反馈与资料回收、多方核查与记录等步骤，其可有效减少失误，确保数字化板的精度，提高患者的就诊体验、工作效率和治疗效果，推动正颌外科的发展和普及。

关键词: 数字化, 正颌外科, 流程, 精准外科

Abstract:

Objective·To establish a standardized procedure of digital orthognathic surgery and to evaluate its effects. Methods·788 patients with dentofacial deformities who received digital orthognathic surgery between 2014 and 2015 were included in this study. Patients were treated based on the procedure of clinical data collection, data processing, computer assisted surgery planning and simulation, 3D printing and occlusal splint processing, orthognathic surgery, surgery evaluation and feedback, and comprehensive verification and recording and the effects of this procedure was evaluated. Results·All 788 patients had satisfactory surgical outcomes.  All preoperative, intraoperative, postoperative, and follow up data and surgeons’ evaluation and feedback were completely recorded. No major mistakes such as occlusal splint lost or mismatch were found. The surgeons, related medical staff, and staff formulating the procedure cooperated smoothly and were satisfied with this procedure. Human errors such as improper adjustment of the occlusal splints or leave them without disinfection were promptly found and dealt with. Conclusion·A standardized digital orthognathic surgery procedure should include clinical data collection and processing, computer assisted surgery planning and simulation, 3D printing and occlusal splint processing, orthognathic surgery, evaluation and feedback, and comprehensive verification and recording, which can effectively eliminate human errors, improve the satisfaction of patients, ensure the accuracy of occlusal splint, enhance efficiency and efficacy, and promote the development and advance of orthognathic surgery.

Key words: digital, orthognathic surgery, procedure； precision surgery