3D技术打印个体化手术导航计划系统治疗原发性三叉神经痛  

A Customized Navigated Template System by 3D Printing for Treatment of Primary Trigeminal Neuralgia

作　　者：顾铁保 张泽锋 王彭 

机构地区：[1]江苏舟可医疗器械科技有限公司,江苏南通226500

出　　处：《中国医疗设备》2015年第11期22-25,15,共5页China Medical Devices

摘　　要：目的探讨3D技术打印个体化手术导航计划系统,辅助经皮卵圆孔穿刺半月神经节射频温控热凝术治疗原发性三叉神经痛的临床价值。方法回顾分析2014年4月~2015年2月接受3D技术打印个体化手术导航计划系统辅助经皮卵圆孔穿刺半月神经节射频温控热凝术治疗原发性三叉神经痛治疗的18例原发性三叉神经痛患者,其中男性6例,女性12例,平均年龄（56.4±15.3）岁。记录穿刺时间、穿刺成功率、疼痛缓解程度以及术中不适情况和术后并发症的情况。所记录结果与2013年在C臂机透视下行同样操作的24例病患进行比较。结果所有患者穿刺均获得成功,术后即刻感觉疼痛明显缓解,与C臂机透视引导穿刺的无显著性差异。借助个体化的手术导航计划系统的平均穿刺时间（2.37±0.64）min显著少于C臂机透视引导穿刺时间（24.2±6.55）min（P〈0.001）,术中患者无明显不适。术后患者未发生面部肿胀及青紫、视力模糊及眼结膜充血红肿或角膜溃疡、张口困难或咀嚼无力、流涎,脑脊液漏或者死亡等并发症。结论 3D技术打印个体化手术导航计划系统,辅助经皮卵圆孔穿刺半月神经节射频温控热凝术操作简便,穿刺精准到位,可以明显缩短手术操作时间,减少术中透视次数,提高穿刺成功率,减少患者痛苦,具有一定的临床推广价值。Objective To explore a novel method for treatment of primary Trigeminal neuralgia（TN）with percutaneous radiofrequency thermocoagulation by virtue of customized navigated template by 3D printing.Methods Altogether 18 patients with primary trigeminal neuralgia who had underwent the customized navigated template system combined with C-arm guided percutaneous radiofrequency trigeminal rhizotomy were reviewed.Among all the patients,there were 6 men and 12 women,with their average age 56.4±15.3 years.Time and efficacy of puncture,relief of pain and complications were recorded.These results were compared to results of 24 cases who accepted single C-arm guided operation in 2013.Results None of intra-operative failures were occurred.All surgeries were made successfully,and pain was released immediately post-operatively.The outcomes did not differ from those of single C-arm guided procedures.However,the average time of puncture by navigated template was significantly reduced compared with that in single C-arm guided procedure（2.37±0.64 min vs 24.2±6.55 min,respectively,P〈 0.001） and the intra-operative dis-comfort of the patients was also decreased.The depth of puncture（9.45±0.58 cm） was mostly close to the results of simulation（9.33±0.87 cm,P〉0.05）.No complications were accompanied.Conclusion The customized navigated template combined with C arm guided treatment was a simply and convenient novel method,which deserved wider promotion for its reduced operation time,decreasing times and improved efficacy of puncture,as well as comfort of patients.

关 键 词：原发性三叉神经痛 经皮卵圆孔穿刺半月神经节射频温控热凝术 计算机辅助设计 3D打印 个体化手术导航计划系统 

分 类 号：R745.11[医药卫生—神经病学与精神病学]