Article(id=1322167830246704000, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322167714660078002, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.02.024, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1743955200000, receivedDateStr=2025-04-07, revisedDate=1766592000000, revisedDateStr=2025-12-25, acceptedDate=null, acceptedDateStr=null, onlineDate=1793158975421, onlineDateStr=2026-10-28, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793158975421, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793158975421, creator=13701087609, updateTime=1793158975421, updator=13701087609, issue=Issue{id=1322167714660078002, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='2', pageStart='177', pageEnd='352', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793158947863, creator='13701087609', updateTime=1793158947863, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=345, endPage=348, ext={EN=ArticleExt(id=1322167832410964865, articleId=1322167830246704000, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Research progress on the application of 3D printing technology in patients with enterostomy, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This review summarizes the application forms and effects of 3D printing technology in patients with enterostomy,outlined the challenges during its implementation,and proposed future directions.Its aim is to provide reference for the precise and individualized care of enterostomy patients.

, authors=Li YUAN, Jiayi SU, Xia LI, Aixin ZHOU, Hua ZHANG, authorsList=Li YUAN, Jiayi SU, Xia LI, Aixin ZHOU, Hua ZHANG, authorCompany=null, correspAuthors=Hua ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Hua, E-mail:
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对3D打印技术在肠造口病人中的应用形式、应用效果进行综述,总结应用过程中的挑战,并提出展望,以期为肠造口病人的精准化和个体化护理提供参考。

, authors=袁莉, 苏家怡, 李霞, 周嫒馨, 张华*, *, authorsList=袁莉, 苏家怡, 李霞, 周嫒馨, 张华, authorCompany=null, correspAuthors=张华, authorNote=

袁莉,护士,硕士研究生在读

, correspAuthorsNote=
张华,E-mail:
ZHANG Hua, E-mail:
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3D打印技术在肠造口病人中应用的研究进展
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袁莉 , 苏家怡 , 李霞 , 周嫒馨 , 张华 *, *
护理研究 | 科研综述 2026,40(2): 345-348
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护理研究 |科研综述 2026 , 40 (2) : 345 -348
3D打印技术在肠造口病人中应用的研究进展
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袁莉, 苏家怡, 李霞, 周嫒馨, 张华*, *
作者信息
  • 1重庆医科大学附属第一医院,重庆 400042
通讯作者:
ZHANG Hua, E-mail:
作者简介:

袁莉,护士,硕士研究生在读

Research progress on the application of 3D printing technology in patients with enterostomy
Li YUAN, Jiayi SU, Xia LI, Aixin ZHOU, Hua ZHANG
Affiliations
  • 1The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042 China
  • Corresponding Author:
    ZHANG Hua, E-mail:
出版时间: 2026-01-25 doi: 10.12102/j.issn.1009-6493.2026.02.024
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对3D打印技术在肠造口病人中的应用形式、应用效果进行综述,总结应用过程中的挑战,并提出展望,以期为肠造口病人的精准化和个体化护理提供参考。

3D打印技术  /  肠造口  /  应用  /  护理  /  综述

This review summarizes the application forms and effects of 3D printing technology in patients with enterostomy,outlined the challenges during its implementation,and proposed future directions.Its aim is to provide reference for the precise and individualized care of enterostomy patients.

3D printing technology  /  enterostomy  /  application  /  nursing  /  review
袁莉, 苏家怡, 李霞, 周嫒馨, 张华. 3D打印技术在肠造口病人中应用的研究进展. 护理研究, 2026 , 40 (2) : 345 -348 . DOI: 10.12102/j.issn.1009-6493.2026.02.024
Li YUAN, Jiayi SU, Xia LI, Aixin ZHOU, Hua ZHANG. Research progress on the application of 3D printing technology in patients with enterostomy[J]. Chinese Nursing Research, 2026 , 40 (2) : 345 -348 . DOI: 10.12102/j.issn.1009-6493.2026.02.024
2022年统计数据显示,结直肠癌发病率在各类癌症中位居第3位[1]。造口手术是治疗结直肠癌的一种常见方法,约10%的结直肠癌病人需要行永久性造口,且为了降低结直肠癌病人术后吻合口漏发生风险,部分病人还会行临时性肠造口[2]。目前,全球造口病人数量呈上升趋势,与造口相关的各种问题也受到医疗保健专业人员广泛关注[3]。尽管造口护理技术和产品已经取得了一定进步,但仍有21%~70%的病人会出现造口并发症,不仅影响病人生活质量,还会增加病人经济负担[4]。造口袋及其相关配件是肠造口病人日常生活必不可少的用品,理想的造口袋能够使造口病人正常参与各种活动,如旅行、运动、家庭生活以及工作等[5]。已有研究结果显示,当前病人对造口袋的使用依然存在许多问题,已有造口袋尚不能满足其生理和心理需求[6]。3D打印技术是一种通过逐层堆积材料制造三维物体的数字化制造技术,其可将数字模型直接转化为实体物体,有利于为制造业带来更高的设计自由度和生产效率,在精准化、个体化医疗中展现出了巨大优势,有力地推动了医学发展[7]。现对3D打印技术在肠造口病人中的应用现状进行综述,以期为肠造口病人的精准个性化护理提供依据。
已有研究显示,我国永久性结肠造口病人已突破100万例,且每年新增病例约为11万例[8]。由于病人或家属术后造口护理技能不足或造口用品使用不当等,使得造口并发症常见,其中造口旁疝在造口术后1年内的发生率为30%~40%,2~3年后可达50%[9]。造口旁疝不仅会导致造口粪便渗漏,还可能因疝嵌顿造成衣物污染及造口袋更换频繁,严重影响病人生活质量[10]。传统造口腹带由于缺乏个体差异化设计,病人佩戴后常出现贴合度不够、压迫效果不佳以及容易移位等问题,影响预防效果[11]。赵改丽等[12]研究纳入70例直肠癌Miles术后永久性结肠造口病人,观察组给予常规护理并结合病人腹部CT数据、身高、体重、腹围、造口位置及大小等个体化参数为其个性化定制3D打印固定片,于术后第7天开始佩戴,同时辅以腹带固定,结果显示,通过个体化设计,3D打印旁疝固定片能够降低病人造口旁疝发生率,减少腹带移位以及造口袋更换频次,提升病人治疗体验。
结肠造口手术是治疗先天性肛门闭锁等疾病的重要手段,病人术后需长期使用造口袋[13]。但目前市面上的造口袋存在硬度较高、成本昂贵等问题,尤其是在新生儿病人中该类问题尤为突出[14]。在此背景下,3D打印技术凭借其高设计自由度、低成本、小批量生产的优势,为个性化造口袋的研发提供了新思路。然而,在3D打印过程中,软质材料[如热塑性弹性体(TPE)]打印参数设置不当容易导致成品硬度不达标的情况[15]。为此,Yeh等[16]通过运用田口方法对3D打印参数进行优化,成功改善了材料性能,降低了对皮肤的摩擦和压迫,从而减少了皮肤损伤以及佩戴不适的情况,使其更适合与新生儿皮肤接触;同时,通过参数优化替代高成本材料,可实现低成本个性化制造的目标;此外,3D打印的个性化底盘能够与新生儿不规则的体表形态完美匹配,有效减少渗漏风险。Wang等[17]使用手持式3D扫描仪对病人造口及周围皮肤进行扫描,借助设计软件设计出与病人造口高度契合的底盘模型,并运用软硅胶材质进行3D打印以制成底盘,其红外传感器可监测排泄物液位,一旦液位达到设定阈值便会触发警报,并借助蓝牙将信号传输至手机APP,提醒病人更换造口袋,微电流刺激器可在液位超标时通过刺激造口周围皮肤,使其产生轻微麻木感,以此模拟肛门的反馈机制,增强病人对造口袋状态的感知能力;该研究还实现了远程适配功能,病人出院后能够利用手机上的免费3D扫描应用定期更新造口形态数据,进而动态调整对底盘的设计。3D打印技术与智能技术有机融合,有利于解决传统造口袋常见的渗漏、皮肤损伤以及使用不便等问题,实现精准、个性化与实时反馈,从而提升病人生活质量。
掌握造口护理技能对病人至关重要,但老年病人认知能力会出现一定程度下降,加之住院时间缩短,使得对病人的教育难度增大[18]。病人往往难以直观理解造口的具体形态,而医护人员与病人在视角上的差异又容易形成沟通障碍,导致皮肤损伤、渗漏等问题频繁发生[19]。3D打印技术能提供高仿真的造口模型,并支持互动式教学,可以成为造口教育的创新性技术保障。Tominaga等[20]采用Artec 3D扫描仪获取病人造口的三维形态数据,随后借助Geomagic Free Form®软件进行三维建模,从而定制造口模型以及底盘模型;利用Objet260 Connex®打印机进行打印,病人借助这些模型能够直观地了解造口形态,并且可以练习裁剪底盘以满足个体化的护理需求;同时,医疗团队也可以利用模型讨论造口护理过程中所面临的问题,从而减少理解上的偏差。Kwong等[21]通过3D打印技术制作能够精准模拟多种造口类型的1∶1比例造口模型,其可紧密贴合病人术前选定的腹部造口位置,为病人术前练习造口操作提供有力支持;术前可由造口专科护士亲自指导病人运用造口模型进行更换造口袋、清洁皮肤等重要操作;居家时病人可在家中利用造口模型完成造口模拟操作以熟练掌握操作流程。3D打印模型尤其适用于高龄以及存在认知障碍的病人群体,有利于弥补传统教育方式存在的不足。
对于行动不便或手部灵活性受限的病人,造口用品的佩戴与更换是一项艰巨的任务,尤其是两件式造口袋,如果操作不当容易出现渗漏问题,因此迫切需要辅助工具简化过程[22-23]。Cosman等[24]通过Fusion 360 软件设计了一种可逆式稳定器原型,该原型能够适配3种标准造口底盘尺寸,并兼容左右侧造口,适于左右手使用;研究者利用3D打印机和聚乳酸(PLA)材料制作原型,并经过7次设计优化,最终确定采用扁平主体加可拆卸手柄结构,既满足了家用需求又具备了便携性。这种设计尤其适合手部灵活性受限的人群,有利于帮助病人依靠单手完成更换,能够有效简化造口袋的更换流程,降低渗漏风险,充分展现了3D打印技术在个性化医疗辅助工具开发中的灵活性和实用性。
赵改丽等[12,25]的研究利用病人腹围、CT数据等个体化信息设计造口旁疝固定片,有利于优化造口周围的受力情况,降低造口旁疝发生率,其选择具有柔韧性、透气性的材料并结合个性化设计,有利于减轻病人佩戴时的不适感,解决传统腹带贴合度不佳、压迫效果不均匀等问题。3D打印技术在改善病人生活质量中具有巨大潜力,为永久性造口病人的护理带来了新机遇。但该技术的应用高度依赖专业设备和专业人员,在推广过程中会面临较大困难。且目前相关研究样本量较小,因此还需更多的研究验证其长期效果。
使用3D扫描技术对病人造口部位进行扫描,生成并打印出与病人造口一致的造口模型,帮助病人更直观地认识造口形态、位置以及护理关键点,具有显著的可视化优势,可为健康教育形式开辟新模式[20]。病人也可使用3D打印技术打印的底盘练习裁剪技巧,有利于减少因底盘与造口不匹配而导致的皮肤或渗漏问题。已有研究结果显示,所有参与3D教育项目的病人在术后首次进行造口核心护理技能评估时都取得了优异的成绩,且有效缓解了他们的术前焦虑情绪,增强了对造口护理的理解及信心,尤其在高龄病人和有合并症的病人中效果明显[21]。未来可通过开展多中心研究及技术优化等推动3D打印技术的广泛应用。
赵改丽等[12]在研究中通过应用3D打印技术打印旁疝固定片,减少了腹带移位次数、造口袋更换频次、渗漏发生情况并延长了造口袋使用时间。通过裁剪训练和3D模型指导可以使病人掌握更多的护理技巧并增强护理信心,同时降低皮肤问题发生率,缩短住院时间[20]。已有研究结果显示,3D教育组的并发症发生情况尤其在肠梗阻和伤口感染方面改善明显且再次手术率有所降低[21]。Wang等[17]研究中3D打印的底盘无须手工裁剪且采用软硅胶材料,具有贴合度高、操作简便等优点,使佩戴时间缩短;研究中联合智能设备(如红外传感器等)实时监测排泄物液位,通过触发手机提醒有利于避免渗漏;利用微电流刺激模拟肛门反馈以增强病人对排泄的感知和控制感,提高了病人的自我管理信心与疾病接受度,减轻了焦虑等心理问题。
个性化3D打印技术为患有肠道疾病的新生儿提供了一种新的造口护理支持技术。Yeh等[16]通过优化3D打印参数使底盘更加贴合新生儿皮肤和不规则的体表,有利于减少排泄物渗漏、降低摩擦和过敏风险,提升了护理安全性以及患儿舒适度。3D打印技术为功能受限而导致造口袋更换困难的病人提供了一种实用的辅助工具,极大地简化了造口袋的更换流程,提升了他们的生活自理能力[24]。
1)造口的形态不是一成不变的,其会随着时间推移发生改变,因此需要病人定期进行3D扫描并根据扫描结果对造口底盘进行相应调整,需要提升病人的依从性和更多的医疗资源投入[26]。2)造口形态具有个体差异性,为了更好地匹配造口形态应该进一步开发更加精准的3D打印技术[27]。3)红外传感器等智能设备的应用在增加造口袋功能多样性的同时也提高了技术复杂度,需要提升设备的长期稳定性和可靠性。4)3D打印成本较高,需要进一步优化生产流程以降低费用,提高可及性。5)3D打印模型的制作过程依赖专业的设备和技术人员,可能限制其在资源有限的医疗机构中的推广和应用。6)老年病人可能由于视力、认知或操作能力不足,难以独立使用3D模型进行学习,限制了技术的广泛应用[28-29]。7)不同教育背景的病人对3D模型的接受度和学习效果可能存在差异,需要制定个性化的教育策略以满足不同病人需求。8)目前,3D打印技术在肠造口病人中的应用研究多为小样本、单中心研究,不利于发现研究存在的问题和进行进一步创新。
1)通过使用3D打印技术,有利于促进个体化精准造口护理,也可以推广至其他个性化医疗设备的生产,从而提升病人舒适度[30]。2)未来可结合人工智能技术开发实时监测系统,增强病人自主管理能力。3)优化微电流刺激传感器以更好地模拟生理反馈机制,帮助病人重建对造口的控制感,增强对疾病的接受度、缓解负性情绪。4)积极探索新型材料以及快速打印技术以缩短生产周期并降低成本。5)结合虚拟现实技术制作互动式的教育工具,进一步提升病人的学习效果[31]。6)降低技术操作门槛,推动其在社区和家庭护理中的广泛应用。7)促进医疗资源分配,使更多病人能够受益于个性化医疗技术。
目前3D打印技术在肠造口病人护理领域的应用仍处于初步探索阶段,3D打印技术的应用为造口护理提供了个性化、精准化的护理方案,提升了病人生活质量。但其广泛应用仍面临诸多困境,如技术精度、材料适配性以及成本和长期有效性、安全性等问题。未来应通过材料创新、多学科协作等方式不断扩大3D打印技术在肠造口中的应用研究,探索更多的应用方式,促进个性化与精准化护理的发展。

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doi: 10.12102/j.issn.1009-6493.2026.02.024
  • 接收时间:2025-04-07
  • 首发时间:2026-10-28
  • 出版时间:2026-01-25
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  • 收稿日期:2025-04-07
  • 修回日期:2025-12-25
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    1重庆医科大学附属第一医院,重庆 400042

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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