基于C形臂的手术入路可视化和导航系统在人体软组织内异物取出术中的应用  

Application of C-arm-based surgical approach visualization and navigation system in removal of foreign bodies in human soft tissue

作　　者：夏德萌 姜里强 周潘宇 张洪跃 吴江红 何滨[2] 许硕贵 XIA De-meng;JIANG Li-qiang;ZHOU Pan-yu;ZHANG Hong-yue;WU Jiang-hong;HE Bin;XU Shuo-gui(Department of Emergency,Changhai Hospital Affi liated to Naval Medical University,Shanghai 200433,China;Department of Orthopedics,Second Affi liated Hospital of Zhejiang University of Traditional Chinese Medicine,Zhejiang Hangzhou 310005,China)

机构地区：[1]海军军医大学附属长海医院急诊科,上海200433 [2]浙江中医药大学第二附属医院骨科,浙江杭州310005

出　　处：《中国医刊》2020年第3期279-282,共4页Chinese Journal of Medicine

基　　金：上海市青年科技“启明星”项目（18QA1405400）;上海申康市级医院新兴前沿技术联合攻关项目（SHDC12017106）;海军军医大学高等级成果培植计划（2018-CGPZ-B04）

摘　　要：目的探讨基于C形臂的手术入路可视化和导航(surgical approach visualization and navigation,SAVN)系统在人体软组织内异物取出术中的应用效果。方法选择2013年9月至2018年6月在海军军医大学附属长海医院应用基于C形臂的SAVN系统进行软组织内异物取出术的患者62例,所有患者均采用SAVN系统确定手术靶点,然后将激光束投射至皮肤,根据SAVN系统指导手术入路的最佳方向和角度,实时引导手术入路至异物取出。结果62例患者均通过一次手术顺利取出异物,每枚异物取出的实际操作(从导针探查至完全取出异物)时间为3~60min,平均(28.9±3.7)min,手术切口的平均大小为(13.15±5.56)mm,平均出血量为(8.52±4.26)ml,术中平均透视次数为(3.73±1.25)次。结论基于C形臂的SAVN系统辅助下取出异物可以准确找到手术靶点,缩短手术时间,减少患者辐射暴露的时间。Objective To investigate the application eff ect of surgical approach visualization and navigation(SAVN)system based on C-arm in foreign body removal in human soft tissue.Method Sixty-two patients were selected from September 2013 to June 2018 at the Changhai Hospital affi liated to Naval Military Medical University with a C-arm-based SAVN system for foreign body removal in soft tissues,including 42 males and 20 females,aged 5-76 years old,average(42.2±12.7)years old.All patients used the SAVN system to determine the surgical target,and then projected the laser beam to the skin.According to the SAVN system,the optimal direction and angle of the surgical approach were guided,and the surgical approach was guided to the removal of foreign objects in real time.Result All the 62 patients successfully removed the foreign body in one operation.The actual operation time(from the probe exploration to the complete removal of the foreign body)for each foreign body was 3 to 60 minutes,with an average of(28.9±3.7)minutes,the average size of incision was(13.15±5.56)mm,the average bleeding volume was(8.52±4.26)ml,and the average number of fl uoroscopy during the operation was(3.73±1.25)times.Conclusion The remov al of metallic foreign b odies with the assistance of SAVN system can fi nd the surgical target accurately,shorten the operation time and reduce th e radiation exposure time of patients.

关 键 词：手术入路可视化和导航系统 软组织内异物 激光 

分 类 号：R649.4[医药卫生—外科学]