导航模板辅助曲针穿刺在隐匿性病灶体外模型上的应用研究  

Applied research of CNP with navigation template in vitro model of concealed lesions

作　　者：李伟 聂慧 段光峰 张汝森 LI Wei;NIE Hui;DUAN Guang-feng(Department of Nuclear Medicine,Affiliated Cancer Hospital&Institute of Guangzhou Medical University,Guangzhou 510095,China;不详)

机构地区：[1]广州医科大学附属肿瘤医院核医学科,广东广州510095 [2]广州医科大学附属肿瘤医院保健病区,广东广州510095 [3]广州医科大学附属肿瘤医院介入科,广东广州510095

出　　处：《中国医学装备》2022年第3期43-48,共6页China Medical Equipment

基　　金：广东省医学科学技术研究基金(A2020254)“基于3D打印导航模板的医用曲针穿刺技术的开发与创新”;广州市卫生健康科技项目(20201A011098)“基于3D打印导板开发可行性的医用曲针穿刺方法”。

摘　　要：目的:研究导航模板辅助曲针穿刺(CNP)在模拟隐匿性病灶体外模型上的应用价值。方法:采用Autodesk 123 D^(*) design软件设计一款包括普通靶区和特殊靶区的体外模型,分别设计一款圆弧形穿刺曲针和一款导航模板,通过3D打印获得实物。分别采用盲穿和CT引导模式,使用常规脊髓穿刺针直针穿刺(SNP)、CNP和导航模板辅助CNP在体外模型上进行穿刺操作,按照引导模式分为盲穿和CT引导。根据穿刺结果计算穿刺完成率、损伤率和穿刺合格率。结果:针对普通靶区,SNP、CNP和导航模板辅助CNP的完成率分别为58.8%、30.0%和73.8%,损伤率分别为56.3%、63.8%和43.8%,穿刺合格率分别为36.3%、13.8%和52.5%;3种穿刺方式间整体的穿刺完成率、损伤率和穿刺合格率比较,差异均有统计学意义(F=6.057,F=6.196,F=7.319;P<0.05)。盲穿和CT引导的穿刺完成率分别为40.8%和67.5%,损伤率分别为65.8%和50.8%,穿刺合格率分别为24.2%和44.2%。针对特殊靶区,CNP和导航模板辅助CNP的穿刺完成率、损伤率及穿刺合格率分别为35.0%和72.5%,92.5%和55.0%,7.5%和45.0%。盲穿和CT引导的穿刺完成率、损伤率及穿刺合格率分别为45.0%和62.5%,80.0%和67.5%,20.0%和32.5%。结论:导航模板辅助CNP技术可以明显提高曲针的可行性,可取得与SNP相似的结果,且对引导模式的依赖小,可弥补SNP在隐匿性病灶的技术缺陷,对于扩大介入穿刺技术的临床应用范围具有重要意义。Objective:To explore the application value of curved needle puncture(CNP) with navigation template in vitro model of conceal lesions.Methods:An in vitro model included common target region and special target region was designed by Autodesk 123 D^(*) design,and an arc-shaped CNP and a navigation template were respectively designed by that,and the material objects were produced by three-dimension(3D) printing.The blind puncture(BP) mode and computed tomography guidance(CTG) mode were adopted respectively,and the conventional spinal cord straight needle puncture(SNP),CNP and CNP with the assistance of navigation template could be used in in vitro model to implement puncture operation,which were divided into BP and CT guidance as the guidance mode.The completion rate,injury rate and qualified rate of puncture were calculated according to the results of puncture.Results:For common target region,the completion rates of SNP,CNP and CNP with assistance of navigation template were 58.8%,30.0% and 73.8%,and the injury rates of them were 56.3%,63.8% and 43.8%,and the qualified rates of puncture of them were 36.3%,13.8% and 52.5%,respectively.The differences of entire completion rate,injury rate and qualified rate of puncture among three kinds of puncture modes were significant(F=6.057,F=6.196,F=7.319,P<0.05).The completion rates of puncture of BP mode and CT guidance were 40.8% and 67.5%,and injury rates of them were 65.8% and 50.8%,and qualified rates of them were 24.2% and 44.2%,respectively.For special target region,the completion rates,injury rates and qualified rates of puncture of CNP and CNP with assistance of navigation template were(35.0% and 72.5%),(92.5% and 55.0%),and(7.5% and 45.0%),respectively.And the completion rates,injury rates and qualified rates of BP and CT guidance were(45.0% and 62.5%),(80.0% and 67.5%) and(20.0% and 32.5%),respectively.Conclusion:CNP with the assistance of navigation template can significantly improve the feasibility of curved needle,and can obtain the similar results with SNP,and ha

关 键 词：3D打印 曲针 导航模板 穿刺 隐匿性病灶 体外模型 

分 类 号：R318[医药卫生—生物医学工程]