辅助穿刺技术用于骶神经调控术的现状和展望  

Current status and prospective of auxiliary puncture techniques in sacral neuromodulation

作　　者：周子钦(综述) 吕坚伟(审校) ZHOU Ziqin;LYU Jianwei(School of Gongli Hospital Medical Technology,University of Shanghai for Science and Technology,Department of Urology,Shanghai Gongli Hospital,Shanghai 200135,China)

机构地区：[1]上海理工大学公利医院医疗技术学院,上海市浦东新区公利医院泌尿外科,上海200135

出　　处：《现代泌尿外科杂志》2024年第10期927-932,共6页Journal of Modern Urology

基　　金：浦东新区中医药传承创新发展示范试点项目浦东新区中西医协同旗舰科室(泌尿外科)项目(No.YC-2023-0405)。

摘　　要：骶神经调控(SNM)术是通过人工植入电极刺激骶神经治疗顽固性排尿功能障碍的重要方法。电极的精准放置一直是临床上的一大难题,而传统穿刺定位方法的精准度不足,促使临床寻找一些辅助穿刺技术运用于SNM。目前应用于临床的SNM辅助穿刺技术除了传统的X线定位技术外,还有计算机断层扫描(CT)引导、超声引导、3D打印引导技术,这些辅助穿刺技术提高了传统方法的精准度和安全性,缩短了手术时间,但部分技术在降低放射性暴露与获取三维视图、实时穿刺引导等方面的权衡上具有一定的挑战。而新兴辅助定位技术如光电导航技术、增强现实手术导航技术、混合现实电磁术中导航技术在临床应用前景上显示出良好的潜力。本文对SNM穿刺的常规定位方法以及最新的辅助穿刺技术进行综述,并进一步分析其未来的发展方向及应用前景。Sacral neuromodulation(SNM)is an essential method for treating refractory voiding dysfunction by artificially stimulating the sacral nerves with implanted electrodes.Precise electrode placement has been a major challenge in clinical practice,as traditional percutaneous techniques lack accuracy.This has driven the search for auxiliary puncture techniques for SNM.Currently,in addition to traditional X-ray guidance,auxiliary puncture techniques employed in clinical SNM mainly include CT-guidance,ultrasound guidance,and 3D printing guidance technology.These auxiliary puncture techniques improve the precision and safety of traditional methods,reduce surgical time,but simultaneously face challenges in balancing reducing radiation exposure,obtaining three-dimensional views,and real-time puncture guidance.Emerging auxiliary localization technologies such as optoelectronic navigation,augmented reality surgical navigation,and mixed reality electromagnetic navigation exhibit promising clinical prospects.This review summarizes the conventional localization methods and the latest auxiliary puncture techniques for SNM,and analyzes their future development directions and application prospects.

关 键 词：骶神经调控 定位方法 辅助穿刺 导航 排尿功能障碍 

分 类 号：R694[医药卫生—泌尿科学]