软组织漂移对电磁导航经颊颅底穿刺影响的动物实验研究  

Influence of Soft tissue Shift in Electromagnetic Navigation-guided Acupuncture of Skull Base: an Animal Study

作　　者：陈敏洁[1] 杨驰[1] 顾力栩[2] 张伟杰[1] 董敏俊[3] 赵晶[2] 张晓虎[1] 邱亚汀[1] 冯志强[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面外科,上海200011 [2]上海交通大学计算机系/软件学院 [3]上海交通大学医学院附属第九人民医院放射科

出　　处：《口腔医学研究》2009年第4期408-411,共4页Journal of Oral Science Research

基　　金：上海市重点(优势)学科建设项目(编号:Y0203);上海交通大学"医工(理)交叉研究基金"项目(编号:YG2007MS30)

摘　　要：目的:测试颊部软组织漂移对电磁导航经颊颅底穿刺精度的影响,从而推断电磁导航辅助半月神经节射频温控热凝术、颅底肿瘤穿吸活检或深部脓肿切排等的可行性。方法:3名初学者分别对3只6月龄山羊的双侧眶下裂进行盲穿和电磁导航辅助穿刺各5次,CT扫描测量穿刺针尖与眶下裂中心点的距离,采用SAS6.12统计软件的t检验和方差分析进行统计学比较。结果:3名实验者盲穿均未进入眶下裂,针尖与眶下裂中心点的平均间距右侧为15 mm,左侧为14.3 mm;电磁导航辅助穿刺时,测量颊部软组织中针尖与预设路径的平均偏差为4.3 mm/6.2,°终点均进入眶下裂,针尖与眶下裂中心点的平均间距右侧为2.7 mm,左侧为2.8 mm;盲穿与导航辅助存在统计学差异(P值范围于0.0008与0.0239之间)。结论:由于终点为骨性孔隙结构,穿刺中途的软组织漂移不影响电磁导航系统的穿刺精度,因此电磁导航可用于半月神经节射频温控热凝术、颅底肿瘤穿吸活检或深部脓肿切排等的精确穿刺。Objective： To evaluate the influence of buccal soft tissue shift on the electromagnetic navigation-guided acupuncture of skull base.Methods： 6 inferior orbital fissures（IOF） of 3 living goats were punctured by 3 beginners.Every one tried by free-hand and by electromagnetic navigation-guided.After each puncture,CT scans were used to measure the distance between the tip of needle and the center of the IOF.t test and variance of SAS 6.12 statistical software was used to analyse. Results： The punctures were failed by free - hand, and the average distance between the tip of needle and the center of the IOF was 15ram in the left sides and 14.3mm in right sides. The punctures were successful by navigation guide, and the average distance between the tip of needle and the center of the IOF was 2.7 mm in the left sides and 2.8 turn in right sides. The average range deviation and the average angular deviation in the bueeal tissue were 4.3 mm and 6.2mm. There was statistical difference between free - hand puncture and navigation - guided puncture （ P range from O. 0008 to 0.0239 ）. ConcLusion ： The surgView - RFT electromagnetic navigation system can overcome the deviations of buceal soft tissue shift, due to the target was bony structure. It could be used in radiofrequeney thermoeoagulation, fine needle biopsy of tumor at skull base or drainage of abscess in deep facial part with minimal error.

关 键 词：电磁导航 穿刺 软组织漂移 眶下裂 活体羊 

分 类 号：R651[医药卫生—外科学]