血管内可操纵导管系统在介入治疗中的应用  

Application of endovascular steerable catheter system in interventional surgery

作　　者：郭婷婷 崔超强 刘宝坤 顾浩 周栋[1] Guo Tingting;Cui Chaoqiang;Liu Baokun;Gu Hao;Zhou Dong(Department of Vascular Surgery,Second Hospital of Lanzhou University,Lanzhou 730030,Gansu Province,China)

机构地区：[1]兰州大学第二医院血管外科,甘肃省兰州市730030

出　　处：《中国组织工程研究》2023年第16期2609-2615,共7页Chinese Journal of Tissue Engineering Research

基　　金：甘肃省自然科学基金(20JR10RA721),项目负责人:周栋。

摘　　要：背景:由于人体的血管形态复杂多样,现已应用于临床中的可操纵导管的手柄与尖端之间由于力的传导不断衰弱使尖端变形常达不到外科医生的预期,这给手术增加了难度。如何在手术中实现可操纵导管尖端快速且精准地变形一直备受外科医生的关注。近年来,随着智能材料的飞速发展,这使在体外远程控制导管尖端变形成为了可能。目的:综述近年来介入治疗中可操纵导管系统的应用进展,以期为可操纵导管系统未来的发展提供有价值的参考。方法:在Web of Science、PubMed、中国知网及万方数据库进行文章检索,文献发表时间为1995-2021年。对比纳入与排除标准将所有文章进行初筛,最终纳入41篇文章进行综述。根据可操纵导管的变形机制,对手动操纵导管系统、磁驱动导管系统以及软材料驱动导管系统的功能特点及临床应用进行总结。结果与结论:①可操纵导管系统的变形机制多种多样,其中手动操纵导管尖端通过远端手柄来操作,使力沿着操纵杆进行传导从而达到尖端的变形;磁驱动导管主要通过在导管尖端加入可通电流的磁铁部分或者计算机控制的永磁体从而在患者体内产生磁场来达到尖端的变形;软材料则通过一些刺激如电或温度等来实现导管尖端变形。②目前手动操纵导管以及磁驱动导管在介入治疗中较为常见,但手动操纵导管因其难以很好的控制以及缺少定位精度给外科医生增加了手术难度,而磁驱动导管(机器人导管系统)因其昂贵的手术费用不能应用于所有患者,因此开发出一类既廉价又可以精准变形的可操纵导管是很有必要的。③形状记忆聚合物类材料价格低廉并且较之前应用于导管的材料有更好的生物相容性以及它们可通过简单的编程在一些适宜人体的刺激条件下(如温度、湿度、磁场和光等)就可进行精准的变形,有较好的医学应用前景�BACKGROUND:Due to the complex and diverse shapes of blood vessels in the human body,the continuous weakening of force conduction between the handle and the tip of the steerable catheter in clinical practice often causes the tip deformation to fail the surgeon’s expectation,which makes the operation more difficult.How to achieve rapid and precise deformation of the steerable catheter tip during surgery has always attracted the attention of surgeons.In recent years,the rapid development of smart materials has made it possible to remotely control the deformation of the catheter tip outside the body.OBJECTIVE:To review research progress of steerable catheter system in recent years in order to provide a valuable reference for the future development of the steerable catheter system.METHODS:Articles were retrieved from Web of Science,PubMed,CNKI and Wanfang Database,and the retrieval time limit was from 1995 to 2021.All articles were initially screened by comparing the inclusion and exclusion criteria,and 41 articles were finally included for review.According to the deformation mechanism of the steerable catheter,the functional characteristics and clinical applications of the manually steerable catheter system,the magnetically driven catheter system and the soft material driven catheter system are summarized.RESULTS AND CONCLUSION:(1)The deformation mechanisms of the steerable catheter system are various,among which:the tip of the manually manipulated catheter is operated by the distal handle,so that the force is conducted along the joystick to achieve the deformation of the tip;the magnetically driven catheter is mainly by adding a magnet part of the current or the computer-controlled permanent magnet generates a magnetic field in the patient to achieve the deformation of the tip;the soft material is used to deform the catheter tip through some stimulation such as electricity or temperature.(2)Manually manipulated catheters and magnetically driven catheters are more common in interventional surgery,but manual manipul

关 键 词：导管 血管 智能材料 驱动 变形机制 尖端 心血管介入治疗 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R605