基于增强现实技术的可视化实时引导系统在股骨头坏死髓芯减压术中定位的初步临床试验  

A preliminary report of visualized real-time navigation system based on augmented reality technology in guide wire positioning of core decompression for femoral head necrosis

作　　者：王淇 姚有杰 邹昆 丁冉[4] 张启栋[4] 王卫国[4] Wang Qi;Yao Youjie;Zou Kun;Ding Ran;Zhang Qidong;Wang Weiguo(Peking University China-Japan Friendship School of Clinical Medicine,Beijing,100029;Beijing Normal University,Beijing,100875;Beijing University of Chinese Medicine,Beijing,100029;Department of Orthopedic Surgery,Beijing Key Lab oflmmunes-Mediated Inflammatory Disease,China-Japan Friendship Hospital,Beijing,100029,China)

机构地区：[1]北京大学中日友好临床医学院,北京100029 [2]北京师范大学,北京100875 [3]北京中医药大学,北京100029 [4]中日友好医院骨科,免疫炎性疾病北京市重点实验室,北京100029

出　　处：《生物骨科材料与临床研究》2021年第5期12-17,共6页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：北京市科技计划(首特)课题(Z171100001017209);国家重点研发计划课题(2017YFC0108102)

摘　　要：目的探讨基于增强现实(AR)技术的可视化实时引导系统用于股骨头坏死微创介入手术定位的可行性、精准度和临床优势。方法试验组纳入2021年1月至2021年3月于本院诊治的9例(10髋)股骨头缺血性坏死患者,在基于AR技术的可视化实时引导系统的辅助下行股骨头坏死髓芯减压术定位穿刺,记录术中定位时长、透视次数,术后利用影像学资料评价系统精度;按照配对原则选择2019年1月至2021年3月行传统股骨头坏死髓芯减压术的患者8例(10髋)作为对照组。对比两组定位时长、透视次数,评估该系统的有效性。结果试验组和对照组的平均定位时长分别为(10.1±1.9)min和(19.1±2.5)min,两者比较差异有统计学意义(P<0.05)。试验组和对照组的平均透视次数分别为(5.5±1.3)次和(14.8±12.1)次,两者比较差异有统计学意义(P<0.05)。试验组平均距离定位误差(5.0±5.2)mm,平均角度定位误差(6.4±2.5)°。两组中均无不良事件发生。结论基于AR技术的可视化实时引导系统相比于传统手术方式,在保证穿刺精度的同时极大程度地减少了定位时长和透视次数。Objective To investigate the feasibility,accuracy,and clinical advantages of a visualized real-time navigation system based on augmented reality(AR)for minimally invasive interventional surgery for femoral head necrosis.Methods The experimental group included 9 patients(10 hips)with femoral head necrosis in China-Japan Friendship Hospital from January 2021 to March 2021,who underwent core decompression surgery with the guidance of visualized real-time navigation system based on AR technology.The intraoperative positioning time of guide wire and the number of fluoroscopy shots were recorded.The virtual navigating screenshot and finial X-ray image were compared to evaluate the accuracy of the system.According to the matching principle,8 patients(10 hips)who underwent routine core decompression surgery for femoral head necrosis in China-Japan Friendship Hospital from January 2019 to March 2021 were included as the control group.The positioning duration and number of fluoroscopy shots between the two groups were compared to evaluate the effectiveness of the navigation system.Results The average positioning time of experimental and control group were(10.1±1.9)min and(19.1±2.5)min respectively,and the difference was statistically significant(P<0.05).The average number of fluoroscopy shots of experimental and control group were(5.5±1.3)times and(14.8±12.1)times respectively,and the difference between two groups was statistically significant(P<0.05).The average distance positioning error of the experimental group was(5.0±5.2)mm,and the average angular positioning error was(6.4±2.5)degrees.No adverse events occurred in both groups.Conclusion Compared with traditional guide wire positioning,the visualized real-time navigation system based on AR technology can significantly reduce the intraoperative positioning time and the fluoroscopy shots while achieving the acceptable puncture accuracy.

关 键 词：增强现实 股骨头坏死 髓芯减压 可视化操作 

分 类 号：R318[医药卫生—生物医学工程] R681[医药卫生—基础医学]