3D打印导板在胸段带状疱疹后神经痛背根神经节脉冲射频治疗中的应用  

Application of 3D-printed navigation plate in pulsed radiofrequency therapy of dorsal root ganglion in thoracic postherpetic neuralgia

作　　者：潘雪芹 王然[2] 赵定亮 张云茜 邵萌萌 韩影[2] 陆丽娟 Pan Xueqin;Wang Ran;Zhao Dingliang;Zhang Yunqian;Shao Mengmeng;Han Ying;Lu Lijuan(Nanjing Drum Tower Clinical College of Xuzhou Medical University,Nanjing 210008,China;Department of Pain Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Medical School of Nanjing University,Nanjing 210093,China)

机构地区：[1]徐州医科大学鼓楼临床学院,南京210008 [2]南京大学医学院附属鼓楼医院疼痛科,南京210008 [3]南京大学医学院,南京210093

出　　处：《中华医学杂志》2021年第43期3542-3548,共7页National Medical Journal of China

基　　金：江苏省重点研发计划(社会发展)(BE2017603);南京市医学重点科技发展项目(ZKX19016)。

摘　　要：目的评价3D打印个体化导航模板在胸段带状疱疹后神经痛(PHN)背根神经节脉冲射频(DRG-PRF)治疗中的精准性、有效性和安全性。方法纳入2019年3月至2020年12月南京大学医学院附属鼓楼医院收治的63例接受DRG-PRF术的胸段PHN患者,随机数字表法分为试验组(n=31)和对照组(n=32)。试验组利用3D打印导航模板辅助背根神经节穿刺,对照组接受常规CT引导下背根神经节穿刺。比较两组的一次穿刺成功率、≥3次穿刺发生率、穿刺次数、穿刺时间、疼痛视觉模拟(VAS)评分、手术并发症。结果试验组一次穿刺成功率为84.9%(79/93),高于对照组的30.2%(29/96)(P<0.001);试验组≥3次穿刺发生率、穿刺次数、穿刺时间分别为4.3%(4/93)、1(1,1)次、2.9(2.8,3.0)min,均低于对照组的21.9%(21/96)、2(1,3)次、9.0(4.5,12.9)min(P<0.01);两组术前、术后各时间点的VAS评分差异均无统计学意义(均P>0.05)。对照组有1例刺破胸膜,两组患者均未发生误入椎管、血肿、脊髓损伤、肢体运动障碍、感染等并发症。结论3D打印个性化导航模板是引导PHN患者行DRG-PRF治疗的有效手段,可显著提升DRG-PRF手术效率,但对手术效果并无明显影响。Objective To evaluate the accuracy,efficacy and safety of 3D-printed personalized navigation template in the treatment of thoracic postherpetic neuralgia(PHN)with dorsal root ganglion pulsed radiofrequency(DRG-PRF).Methods A total of 63 patients with thoracic PHN from March 2019 to December 2020 in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School were enrolled and randomly divided into study group(n=31)and control group(n=32)by random number table method.The study group received DRG-PRF treatment assisted by 3D-printed navigation template,while the control group received DRG-PRF treatment guided by conventional CT.The one-time success rate of puncture,the incidence of puncture times≥3,the number of punctures,puncture time,visual analogue scale(VAS)score and surgical complications between the two groups were compared.Results The one-time success rate of puncture in study group was 84.9%(79/93),which was higher than that of control group[30.2%(29/96)](P<0.001).The incidence of puncture times≥3,the number of punctures,puncture time in study group were 4.3%(4/93),1(1,1)and 2.9(2.8,3.0)min,respectively,which were lower than that of the control group[21.9%(21/96),2(1,3),9.0(4.5,12.9)min,respectively](all P<0.01).No difference was found in VAS score at each time point before and after surgery between the two groups(all P>0.05).There was one case of pleura puncture in the control group,but no other complications such as straying into vertebral canal,hematoma,spinal cord injury,limb movement disorder,infection were found in the two groups.Conclusions 3D-printed personalized navigation template is an effective method to guide DRG-PRF for the treatment of thoracic postherpetic neuralgia.It can significantly improve the surgical efficiency of DRG-PRF,but has no significant effect on the surgical efficacy.

关 键 词：神经节 脊 神经痛 带状疱疹后 脉冲射频 3D打印技术 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]