机器人三维靶向定位系统在CT引导下肺穿刺活检术中的应用  

Clinical application of robotic three-dimensional targeting system in CT-guided lung biopsy

作　　者：陈晓霞[1] 刘昊[1] 赵国全[1] 王倜 侯文文 王贵生[1] 王楚涵 CHEN Xiaoxia;LIU Hao;ZHAO Guoquan;WANG Ti;HOU Wenwen;WANG Guisheng;WANG Chuhan(Radiology Department of General Hospital of Chinese People＇s Armed Police Force,Beijing 100039,China;Capital Medical Univarsity School of Bosic Medical Sciences,Beijing 100069,China)

机构地区：[1]武警总医院CT科,北京100039 [2]首都医科大学基础医学院

出　　处：《武警医学》2018年第8期758-761,765,共5页Medical Journal of the Chinese People's Armed Police Force

基　　金：首都临床特色应用研究项目(Z151100004015148);武警总医院院级课题(WZ2015018);武警总医院院级基础类课题(WZ2014009)

摘　　要：目的探讨MAXIOTM机器人三维靶向定位系统在CT引导下肺穿刺活检术中的应用。方法选择2017-08至09 40例经评估适合行肺穿刺活检术患者,随机分为试验组和对照组,每组20例。试验组采用MAXIOTM机器人三维靶向定位系统在CT引导下行肺穿刺活检术,对照组采用传统格栅定位器行CT引导下穿刺活检。比较试验组与对照组平均操作时间、一次性穿刺成功率、扫描次数、并发症发生率、活检病理诊断阳性率。结果试验组和对照组肺穿刺平均操作时间分别为(24.0±3.9)min和(27.3±4.1)min,两组比较差异无统计学意义(t=-1.91,P>0.05);试验组和对照组一次性穿刺成功率分别为75%(15/20)和25%(5/20),两组比较差异有统计学意义(χ~2=8.10,P<0.05);试验组和对照组平均扫描次数分别为(4.1±0.5)次和(6.0±1.3)次,两组比较差异有统计学意义(t=-4.65,P<0.05);试验组和对照组并发症发生率分别为10%(2/20)和40%(8/20),两组比较差异有统计学意义(χ~2=4.68,P<0.05);试验组和对照组活检病理诊断阳性率分别为100%(20/20)和90%(18/20),两组比较差异无统计学意义(χ~2=2.05,P>0.05)。结论 MAXIOTM机器人三维靶向定位系统在CT引导下肺穿刺活检术前较为精确地规划了穿刺路径,机械臂实时立体引导操作,一次性穿刺成功率提高,扫描次数减少,辐射剂量降低,并发症发生率低,具有较高的临床应用价值。Objective To explore the clinical value of MAXIOTM robotic three-dimensional targeting system in lung puncture biopsy guided by CT. Methods Between August and September 2017,40 patients were randomly divided into the experimental group and control group. The experimental group adopted the MAXIOTM robotic three-dimensional targeting positioning system in the CT guided descending pulmonary puncture biopsy,while the control group was guided by the traditional grid locator to conduct the puncture biopsy. The average length of operation,one-time puncture success rate,scanning frequency,complication rate and biopsy pathological diagnosis rate were compared between the two groups. Results The average length of operation of lung puncture in the experimental group and control group was（ 24. 0 ± 3. 9） min and（ 27. 3 ± 4. 1） min respectively,so the difference between the two groups was not statistically significant（ t =-1. 91,P〈0. 05）. The one-time puncture success rate of the experimental group and control group was75%（ 15/20） and 25%（ 5/20） respectively,suggesting that the difference between the two groups was statistically significant（ χ-2=8. 10,P〈0. 05）. The average scanning times of the experimental group and the control group were（ 4. 1 ± 0. 5） times and（ 6. 0 ±1. 3） times respectively,and the difference between the two groups was statistically significant（ t =-4. 65,P〈0. 05）. The incidence of complications was 10%（ 2/20） and 40%（ 8/20） respectively in the experimental group and the control group so that the difference between the two groups was statistically significant（ χ-2= 4. 68,P〈0. 05）. The positive rate of test in the experimental group and the control group was 100%（ 20/20） and 90%（ 18/20） respectively,so the difference between the two groups was not statistically significant（ χ-2= 2. 05,P〉0. 05）. Conclusions The MAXIOTM robotic3 D targeting system can accurately plan the puncture path before CTguided lung biopsy. The real-time stereo

关 键 词：肺穿刺活检术 CT引导 三维靶向定位系统 肺部病变 

分 类 号：R445.3[医药卫生—影像医学与核医学]