[1]廖政文,莫诒向,张国栋,等.3D打印个性化康复矫形器的设计制作[J].中国医学物理学杂志,2018,35(4):470-477.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.019]
　LIAO Zhengwen,MO Yixiang,ZHANG Guodong,et al. Design and development of three-dimensional printing personalized rehabilitation orthosis[J].Chinese Journal of Medical Physics,2018,35(4):470-477.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.019]
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3D打印个性化康复矫形器的设计制作()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第4期
页码:
470-477
栏目:
生物材料与力学
出版日期:
2018-04-21

文章信息/Info

Title:
 Design and development of three-dimensional printing personalized rehabilitation orthosis
文章编号:
1005-202X（2018）04-0470-08
作者:
 廖政文1; 2; 3; 莫诒向2; 张国栋2; 4; 林晖2; 4; 黄国志3; 黄文华1; 2; 4
1.广西医科大学基础医学院， 广西 南宁 530021； 2.南方医科大学基础医学院， 广东 广州 510515； 3.南方医科大学附属珠江医院康复医学科， 广东 广州510280； 4.广东省医学3D打印应用转化工程技术研究中心， 广东 广州 510515
Author(s):
 LIAO Zhengwen1; 2; 3;  MO Yixiang2;  ZHANG Guodong2; 4;  LIN Hui2; 4;  HUANG Guozhi3;  HUANG Wenhua1; 2; 4
 1. College of Basic Medical Sciences, Guangxi Medical University, Nanning 530021, China; 2. College of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China; 3. Department of Rehabilitation Medicine, Zhujiang Hospital Affiliated to Southern Medical University, Guangzhou 510280, China; 4. Guangdong Medical Center for 3D Printing Application Conversion Engineering, Guangzhou 510515, China
关键词:
 ; 3D打印; 康复矫形器; 数字化设计; 个性化
Keywords:
three-dimensional printing;  rehabilitation orthosis;  digital design;  personalized
分类号:
R312；R197.39
DOI:
DOI:10.3969/j.issn.1005-202X.2018.04.019
文献标志码:
A
摘要:
 目的：基于3D打印技术个性化康复矫形器的数字化设计制作研究，提出一种3D打印制作康复矫形器的可行性方案。 方法：（1）用MRI的T1-mDIXON-W扫描模式扫描上肢，采集上肢肘以下前臂部分DICOM格式影像数据刻录成光盘，将光盘的数据导入Mimics软件重建出皮肤轮廓模型并导出STL格式文件，将STL格式文件导入Geomagic studio软件进行表面优化、网格划分、精确曲面等操作实体模型后保存为STP格式文件，将STP格式模型文件导入到Abaqus软件进行有限元结构的优化分析，设置10组不同的优化数值（5%、10%、15%、20%、25%、30%、35%、40%、45%、50%）分别进行拓扑优化，从而找到合适的优化数值，实现模型结构的优化，根据优化结果图和应力云图，指导模型的挖孔设计，设计好矫形器的模型，最后用尼龙材料通过3D打印机打印出来；（2）通过30个志愿者[男15人，女15人，年龄（24.26±2.38）岁，体质量（59.67±10.63） kg）]佩戴该方案设计制作的3D打印个性化矫形器和传统方法手工制作的矫形器，填写魁北克辅助科技满意度评估调查表，将表格数据用SPSS 19.0软件进行统计学分析。 结果：（1）通过有限元拓扑优化分析，经过多次尝试，发现优化的体积参数设置在10%~20%之间，模型的生物力学性能影响较小，对照有限元优化结果指导模型的挖孔设计；（2）分析30个志愿者填写的魁北克辅助科技使用者满意度评估量表，可见矫形器使用的舒适度、矫形器使用的简易度、矫形器的性价比、矫形器的重量、外表美观性、矫形器的透气性均呈现出显著性（P<0.05），意味着矫形器这6项指标有着统计意义上的差异，得出3D打印的矫形器在透气性和重量等方面优于传统矫形器。 结论：本研究开发的3D打印康复矫形器的设计制作方案是可用的，能够为将来3D打印康复矫形器的大量临床应用提供参考。
Abstract:
 Objective To propose a feasible scheme for making rehabilitation orthosis using three-dimensional (3D) printing technology based on research of digital design and manufacture of personalized rehabilitation orthosis with the use of 3D printing technology. Methods We used the T1-mDIXON-W scanning mode of magnetic resonance imaging to scan the upper limbs, collected DICOM format image data of the upper arm elbow and burned them into CD-ROM, imported the data of the CD-ROM into Mimics software to reconstruct the skin contour model, and exported the STL format file. The STL format file was imported into Geomagic studio software for surface optimization, meshing, precise surface manipulation, and the results were saved as STP format files which were imported into Abaqus software for optimization analysis of the finite element structure. Ten sets of different optimization values were set, namely 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, which were applied for topological optimization, respectively, in order to determine the appropriate optimization value and optimize the model structure. According to the optimization result map and stress cloud map, we guided the dig hole design of model, designed a model of the orthosis, and finally used a nylon material to print it out through a 3D printer. A total of 30 volunteers aging (24.26 ± 2.38) years old and weighing (59.67 ± 10.63) kg, including 15 male and 15 female, wore 3D printed personalized orthoses designed and manufactured using this program and traditional hand-made orthoses, and then filled in Quebec User Evaluation of Satisfaction with Assistive Technology. Finally, SPSS 19.0 software was applied to analyze the evaluation data. Results After finite element topology optimization analysis and several attempts, it was found that the optimized volume parameter was set between 10% and 20%, and the biomechanical performance of the model was less affected, and the digging hole design was guided by the finite element optimization results. The Quebec User Evaluation of Satisfaction with Assistive Technology filled by 30 volunteers was analyzed, and the results revealed that the comfort, simplicity, cost performance, weight, aesthetic appearance, and breathability of the orthosis were all significant (P<0.05), implying that the indicators of the 6 items of the orthosis had statistically significant differences. 3D printed orthosis was proven to be superior to traditional orthotics in some aspects, such as breathability and weight. Conclusion The 3D printing rehabilitation orthosis design and production program developed in this study is available, which can provide reference for the future clinical application of 3D printing rehabilitation orthosis.

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备注/Memo

备注/Memo:
 【收稿日期】2018-03-11
【基金项目】国家自然科学基金（61427807）；广东省科技计划项目（2016B090917001, 2015B010125005）；中国南方智谷引进创新团队项目（2015CXTD05）
【作者简介】廖政文，硕士在读，主要研究方向：临床应用解剖学及医学3D打印，E-mail: 960984540@qq.com
【通信作者】黄文华，博士生导师，教授，主要研究方向：临床应用解剖学、医学3D打印应用转化、数字医学，E-mail: 13822232749@139.com；黄国志，博士生导师，主任医师，主要研究方向：信息技术在康复医学中的应用、神经骨骼肌肉疾病的康复等，E-mail: drhuang66@163.com
更新日期/Last Update: 2018-04-23