混合现实在听神经瘤手术治疗与医患沟通中的应用  

Application of Mixed Reality Technology in Surgical Resection of Vestibular Schwannoma and Doctor-patient Communication

作　　者：杨吉鹏[1] 李晓瞳 王同聚 李琛[1] 李朝晖[1] 胡红超[1] 孙晓枫[1] YANG Jipeng;LI Xiaotong;WANG Tongju;LI Chen;LI Zhaohui;HU Hongchao;SUN Xiaofeng(Department of Neurosurgery,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Radiology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Neurosurgery,Lincheng County People’s Hospital,Xingtai 054300,China)

机构地区：[1]河北医科大学第二医院神经外科,石家庄050000 [2]河北医科大学第二医院医学影像科,石家庄050000 [3]临城县人民医院神经外科,邢台054300

出　　处：《肿瘤防治研究》2021年第8期788-793,共6页Cancer Research on Prevention and Treatment

基　　金：河北省重点研发计划项目民生科技专项(20377703D);河北省科技厅-河北医科大学“厅校会商基金-科技创新”项目(2020TXJC03)。

摘　　要：目的探讨混合现实技术在听神经瘤手术治疗与医患沟通的应用价值及意义。方法随机选取13例接受手术治疗的听神经瘤患者,术前建立三维模型并利用混合现实技术制定手术方案与辅助医患谈话,术中利用混合现实辅助乙状窦后入路开颅、肿瘤切除与面神经的保护,收集医患沟通调查问卷并记录患者术后1周的面神经功能。结果利用混合现实技术成功显示13例听神经瘤全息模型影像,10例术前重建的面神经位置与术中实际位置完全符合(84.6%),经术前分析后决定磨除部分内听道后壁11例;13例医患沟通调查问卷均提示家属与患者对病情、手术方式及风险理解透彻,对术前谈话过程表示满意;13例均实现肿瘤全切,术中无1例静脉窦损伤,术后1周患者面神经功能Ⅰ级(House-Brackmann分级)3例,Ⅱ级6例,Ⅲ级3例,Ⅳ级1例。结论混合现实技术有助于术前制定个体化的听神经瘤手术方案、提高医患沟通效率,可作为一种手术辅助手段减少手术副损伤、有助于保留面神经的功能。Objective To investigate application value and significance of mixed reality technology in surgical treatment and doctor-patient communication for vestibular schwannoma.Methods We selected randomly 13 vestibular schwannoma patients treated with surgical treatment.After the three-dimensional models were constructed,preoperative surgical planning and doctor-patient communication were performed with mixed reality technology.Craniotomy through retrosigmoid sinus approach,tumor resection and facial nerve protection were achieved intraoperatively with the assistance of mixed reality technology.Questionnaires were collected and facial nerve function of 13 patients was recorded one week after operation.Results Holographic model images of 13 cases were showed successfully using mixed reality technology.The locations of preoperative facial nerves reconstructed were completely consistent with actual locations in 10 cases(84.6%).After preoperative anatomic analysis,it was decided to remove partly the posterior wall of the internal auditory canal in 11 cases.The result of doctor-patient communication questionnaire showed that 13 patients and their family all had a thorough understanding of the condition,operative plan and risks,and expressed satisfaction with the preoperative conversation.With the assistance of mixed reality technology,the tumors were resected totally without injury of vein sinus in 13 cases.The facial nerve function was gradeⅠin 3 cases,gradeⅡin 6 cases,gradeⅢin 3 case and gradeⅣin 1 case based on House-Brackmann grading one week after surgery.Conclusion Mixed reality technology is quite helpful in individual surgical planning and preoperative doctor-patient communication.It helps reduce the side injuries of surgery and protect the function of facial nerve as a surgical assistant tool intraoperatively.

关 键 词：混合现实 听神经瘤 手术 面神经 

分 类 号：R739.43[医药卫生—肿瘤]