定位装置辅助下四肢深部金属异物的精准定位及取出  

Accurate localization and removal of deeply imbedded metallic foreign bodies in human limbs assisted by positioning device

作　　者：苏炜炜 何藻鹏 张国栋 李卫 许靖[4] 廖政文 谢普生 林东鑫 黄文华 Su Weiwei;He Zaopeng;Zhang Guodong;Li Wei;Xu Jing;Liao Zhengwen;Xie Pusheng;Lin Dongxin;Huang Wenhua(Department of Orthopedics,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China;Department of Anatomy,Guangdong Provincial Key Laboratory of Medical Biomechanics,Southern Medical University,Guangzhou 510515,China;Hand&Foot Surgery,Plastic Surgery,Shunde Hospital of Guangzhou Medical University,Foshan 528300,China;Department of Orthopedics,Shunde Hospital of Southern Medical University,Foshan 528300,China;Department of Rehabilitation Medicine,Zhujiang Hospital of Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学第三附属医院骨科,广州510630 [2]南方医科大学基础医学院人体解剖学教研室,广东省医学生物力学重点实验室,广州510515 [3]广州医科大学附属顺德医院手足整形外科,广东佛山528300 [4]南方医科大学附属顺德医院骨科,广东佛山528300 [5]南方医科大学附属珠江医院康复医学科,广州510280

出　　处：《中国临床解剖学杂志》2021年第2期148-153,共6页Chinese Journal of Clinical Anatomy

基　　金：国家重点研发计划(2017YFC1103400);国家自然基金(21773199,31972915);深圳市医疗卫生“三名工程”高层次医学团队(SZSM201612019);佛山市创新驱动助力工程:钟世镇院士专家工作站(2019012);佛山市医学科技创新平台项目(2017AG100243)。

摘　　要：目的探讨新型定位装置在四肢深部金属异物精准定位及取出术中的应用。方法选取成人尸体防腐上、下肢标本10侧,置入φ2.0 mm金属球造模65例,分为实验组和对照组,前者为65例异物的实际定位结果,后者为理论上65例异物的定位结果。在定位装置辅助下定位,之后进行薄层CT扫描和三维重建,测量定位偏差距离(D1),统计不同精度等级的合格定位数,进行卡方检验,获得定位装置的定位精度,记录透视时间(T1)和异物取出时间(T2)。结果65例金属异物全部实现精准定位并取出;T1=(46.06±18.44)s,T2=(177.10±65.87)s;该定位装置的定位精度为2.3 mm。结论借助定位装置可实现四肢深部金属异物的精准定位及取出。Objective To explore the application of the new positioning device on the accurate localization and removal surgery of deeply imbedded metallic foreign bodies.Methods Ten human limb specimens were used and 65 metal balls with a diameter of 2.0 mm were inserted.This experiment was divided into an experimental group,which was the actual locating result of the 65 cases of foreign bodies,and a control group,which was the theoretical optimal locating result of the 65 cases of foreign bodies.After localization with assistance of the locating device,a thin layer CT scan and 3 D reconstruction were performed to measure the positioning deviation distance(D1).The qualified positioning numbers of different accuracy levels was counted.The chi square test was performed to obtain the positioning accuracy of the locating device and the fluoroscopy time(T1)and removal time of the foreign body(T2)were recorded.Results All 65 metallic foreign bodies were located and removed precisely,with mean T1:46.06±18.44 seconds and T2:177.10±65.87 seconds.The location accuracy of this device was 2.3 mm.Conclusions With the aid of this positioning device,the precise localization and removal of deeply embedded metallic foreign bodies in human limbs can be achieved.

关 键 词：金属异物残留 精准定位 3D打印 透视 

分 类 号：R608[医药卫生—外科学]