3D打印经皮穿刺导航系统在半月神经节射频热凝术中的应用  

3D PRINTING PUNCTURE NAVIGATION MODULE-GUIDED PERCUTANEOUS RADIOFREQUENCY THERMOCOAGULATION FOR TREATMENT OF TRIGEMINAL NEURALGIA

作　　者：陆丽娟[1] 韩影[1] 槐洪波[1] 谢菡[2] 

机构地区：[1]南京大学医学院附属鼓楼医院疼痛科,南京210008 [2]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《中国疼痛医学杂志》2015年第12期914-918,共5页Chinese Journal of Pain Medicine

摘　　要：目的:评估3D打印个性化经皮穿刺导航系统应用于半月神经节射频热凝术的有效性。方法:60例符合国际头痛学会分类委员会确定的原发性三叉神经痛诊断标准、有射频热凝术适应症的患者随机分为A组(3D打印组,n=30)和B组(对照组,n=30),A组在导航系统引导下行半月神经节射频热凝术,B组在常规CT引导下行半月神经节射频热凝术,记录经皮穿刺到达靶点所需时间、一次穿刺成功率、手术时间、CT扫描次数;患者术中反应(呻吟、肢动等);患者术后即刻、术后7 d、30 d疼痛完全缓解率、病人满意率;术后1 m、3 m、6 m优良率评估;术中(或术后)脑脊液渗漏、面部淤血肿胀等不良反应发生率。结果:与对照组相比,A组在穿刺到达靶点时间、手术时间、CT扫描次数、术中及术后不良反应发生率等方面明显减少或降低(P<0.05),而在一次性穿刺成功率、手术即刻疼痛完全缓解率、患者满意度、术后1 m、3 m、6 m优良率方面明显高于对照组(P<0.05)。结论:3D打印个性化经皮穿刺导航系统辅助半月神经节射频热凝术可以提高穿刺成功率、缩短手术时间、减少患者损伤、降低并发症发生率、提高手术安全性,具有较好的学术价值和临床应用前景。Objective： To evaluate the effectiveness of the 3D printing puncture navigation system guided radiofrequency thermocoagulation for the treatment of trigeminal neuralgia. Methods： Sixty hospitalized patients with trigeminal neuralgia were randomly divided into group A（3D printing group, n = 30） and group B（control group, n = 30）. Group A patients were treated under the guidance of navigation system. Group B patients were treated under the routine CT guide. The time consumed for puncture, success rate of one-time puncture, operation time, the number of CT scan were recorded. The response of patients during surgery（groaning, moving etc）, the postoperative numerical rating scale（NRS） and clinical efficacy（1m, 3m, 6m） as well as complications were also evaluated. Results： The operation time and CT scan times as well as complications in group A were significantly reduced compared with group B. The success rate in one-time, clinical efficacy rate（1 m, 3 m, 6 m） and patient satisfaction in group A were also much better than the control group. Conclusion： 3D printing navigation system-guided percutaneous radiofrequency may raise the success rate of puncture, shorten operative time, enhance the safety and reduce the incidence of complication. This technique has the potential to be widely used in clinic.

关 键 词：数字化设计 3D打印 导航模块 经皮穿刺三叉神经半月节射频热凝术 三叉神经痛 

分 类 号：R745.11[医药卫生—神经病学与精神病学]