增强现实技术辅助枕下乙状窦后锁孔入路开颅术的应用价值  

Application efficiency of augmented reality technology in craniotomy with suboccipital retrosigmoid keyhole approach

作　　者：孙博宇 宋燕飞 吴子睿 孙国柱[1] Sun Boyu;Song Yanfei;Wu Zirui;Sun Guozhu(Department of Neurosurgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,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]河北省临城人民县医院

出　　处：《脑与神经疾病杂志》2024年第10期651-655,共5页Journal of Brain and Nervous Diseases

基　　金：河北省重点研发计划项目-民生科技专项(2237717D);河北省科技厅-河北医科大学“厅校会商基金-科技创新”项目(2020TXJC02);河北省医学科学研究课题计划(20210008、20221600、20230032);河北省医学适用技术跟踪项目(GZ2022018)。

摘　　要：目的探讨增强现实(AR)技术在辅助枕下乙状窦后锁孔入路开颅术的应用价值。方法回顾2021年9月至2023年12月于河北医科大学第二医院神经外科诊治的76例接受枕下乙状窦后锁孔入路开颅患者的临床资料。按是否接受AR辅助骨瓣成型分为AR组(40例)和对照组(36例)。AR组应用3D Slicer软件重建包括横窦和乙状窦等结构在内的3D影像学模型,应用AR技术在头皮标记横窦和乙状窦走形,并定位关键孔,完成枕下乙状窦后锁孔入路开颅,对照组则根据影像学结果凭经验完成骨瓣成型。结果AR组患者均成功重建3D影像学模型,并应用AR技术顺利辅助枕下乙状窦后锁孔入路开颅。与对照组比较,AR组开颅时间缩短,骨窗面积减少,关建孔定位更准确。出血量、静脉窦损伤和术后皮下积液发生率也优于对照组。结论AR技术能够准确辅助标定横窦和乙状窦走形,精准定位关键孔,对乙状窦后锁孔入路实现开颅微创化、精准化和减少术后并发症具有重要意义。Objective To evaluate the application efficiency of augmented reality(AR)technology in craniotomy with suboccipital retrosigmoid keyhole approach.Methods The clinical data of 76 patients with suboccipital retrosigmoid keyhole approach admitted to the Department of Neurosurgery,the Second Hospital of Hebei Medical University from September 2021 to December 2023 were retrospectively analyzed.Patients were divided into AR group(40 cases)and control group(36 cases)according to whether they were received AR assisted craniotomy.The 3D models of AR group,including transverse and sigmoid sinuses,were reconstructed using 3D Slicer software.AR technology was employed to mark the curse of transverse sinus and sigmoid sinuses and locate the keyhole,performing the keyhole craniotomy.The control group empirically underwent bone craniotomy according to imaging results.Results 3D imaging models of all patients in the AR group were successfully reconstructed,and keyhole craniotomy with aid of AR technology were performed.Compared with control group,the craniotomy time of AR group was shortened,the bone window area was reduced,and the keyhole was more accurately located.The amount of bleeding,the incidence of venous sinus injury and postoperative subcutaneous fluid accumulation were also significantly lower than that of control group.Conclusion AR technology can accurately assist in marking the course of transverse sinus and sigmoid sinuses,and locating keyhole,which is of great significance for achieving minimal invasion and precision in craniotomy of suboccipital retrosigmoid keyhole approach,and reducing postoperative complications.

关 键 词：增强现实技术 枕下乙状窦后锁孔入路 显微手术 

分 类 号：R739.4[医药卫生—肿瘤]