磁场导航智能定位系统引导穿刺准确性评估的实验研究  

The accuracy of puncture guided by intelligent positioning system using magnetic navigation

作　　者：郭乐杭[1,2] 徐辉雄[1,2] 王帅[1,2] 何勇[1,2] 刘畅[1,2] 刘琳娜[1,2] 张一峰[1,2] 徐军妹[1,2] 孙丽萍[1,2] 

机构地区：[1]同济大学附属第十人民医院 [2]上海市第十人民医院超声医学科,200072

出　　处：《中华医学超声杂志（电子版）》2013年第6期500-504,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金资助项目(30970837);教育部新世纪优秀人才支持计划项目(NCET-06-0723)

摘　　要：目的评估磁场导航智能定位(IP)系统引导穿刺的准确性。方法将煮熟的鹌鹑蛋包埋于魔芋凝胶制备实验模型,以蛋黄中心作为穿刺目标,按穿刺目标深度分为近距离组(穿刺目标深度<50 mm)、中距离组(穿刺目标深度50～100 mm)和远距离组(穿刺目标深度>100 mm),每组分别采用IP系统引导和常规超声引导各穿刺5个模型。测量、计算并比较穿刺误差(穿刺针道与穿刺目标的距离),记录并比较穿刺次数和穿刺用时。结果对于近、中、远距离目标,IP系统引导穿刺误差分别为(1.88±1.18)、(1.56±0.56)、(3.99±1.10)cm,常规超声引导穿刺误差分别为(4.52±2.23)、(4.49±1.73)、(3.93±2.19)cm。对于近、中距离目标,IP系统引导穿刺误差均小于常规超声引导,且差异均有统计学意义(t=-2.345,P=0.047;t=-3.608,P=0.007);而对于远距离目标,IP系统引导与常规超声引导的穿刺误差间差异无统计学意义(t=0.058,P=0.955)。IP系统引导下,对于远距离目标的穿刺误差均大于近、中距离目标,且差异均有统计学意义(t=1.073,P=0.011;t=-0.188,P=0.042);而近距离目标与中距离目标的穿刺误差间差异无统计学意义(t=-1.927,P=0.501)。IP系统引导下均一次完成穿刺;对于近、中、远距离目标,常规超声引导穿刺次数中位数分别为2、1、2次。对于近、远距离目标,IP系统引导穿刺次数均少于常规超声引导,且差异均有统计学意义(U=-2.372,P=0.018;U=-2.390,P=0.032);而对于中距离目标,IP系统引导与常规超声引导穿刺次数间差异无统计学意义(U=-1.000,P=0.690)。对于近、中、远距离目标,IP系统引导穿刺用时分别为(21.20±2.39)、(27.00±4.00)、(31.80±3.83)s,常规超声引导穿刺用时分别为(45.20±9.68)、(26.80±4.21)、(54.60±13.48)s。对于近、远距离目标,IP系统引导穿刺用时均明显少于常规超声引导,且差异均有统计学意义(t=-5.383,P=0.001;t=-3.637,P=0.007);而对于中距离目标,IP系统引�Objective To assess the accuracy of puncture guided by intelligent positioning (IP) system using magnetic navigation.Methods Five prepared targeted models at three certain depth (<50 mm, samll depth;50-100 mm,medium depth;>100 mm,large depth) underwent puncture guided by intelligent positioning system using IP and conventional ultrasound (US),respectively.Puncture errors,the number of attempt and spent time were recorded and compared .Results For the targets at small,medium and large depth,the errors of IP was (1.88 ±1.18),(1.56 ±0.56) and (3.99 ±1.10) cm,and the errors of conventional US was (4.52 ±2.23),(4.49 ±1.73) and (3.93 ±2.19) cm respectively.The errors of IP were significantly less than those of conventional US at small(t=-2.345,P=0.047) and medium(t=-3.608,P=0.007) depth,but there was no statistically significant difference at large depth (t=0.058,P=0.955). In the IP group,there were statistically significant differences for puncture errors between the small and large depth,as well as between medium and large depth ( F =8.923,P =0.010).There was no statistically significant difference for the errors of IP between the small and medium depth (t=-1.927,P=0.501).For the targets at small,medium and large depth,each puncture was performed in single attempt when guided by IP and in 2,1 and 2 attempt when guided by conventional US .At small and large depth,the numbers of attempt of IP were significantly less than those of conventional US (U=-2.372,P=0.018;U=-2.39, P=0.032).Whereas at medium depth,there was no significant difference (U=-1.000,P=0.690).For the targets at small,medium and large depth,each puncture spent (21.20 ±2.39)s, (27.00 ±4.00)s and (31.80 ±3.83)s when guided by IP,and(45.20 ±9.68),(26.80 ±4.21) and (54.60 ±13.48)s when guided by conventional US.The spent time of IP was less than that with conventional US for small and large depth targets(t =-5.383, P =0.001;t =-3.637, P =0.007).Whereas no statistically significant difference was found for the medium depth target (t=0.077,P=0.916)

关 键 词：超声检查 磁场导航 智能定位 穿刺术 

分 类 号：R197.39[医药卫生—卫生事业管理]