机器人辅助与DSA引导经皮穿刺三叉神经球囊压迫术临床对比分析  

Clinical comparative analysis of robot-assisted and DSA-guided percutaneous balloon compression for the treatment of trigeminal neuralgia

作　　者：苏复海 陈云鹏[2] 梁有明 闭水清 徐鹏[1] 蓝胜勇[1] SU Fuhai;CHEN Yunpeng;LIANG Youming;BI Shuiqing;XU Peng;LAN Shengyong(Department of Neurosurgery,People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China;Department of Neurosurgery,Guangxi Hospital Division of the First Affiliated Hospital of Sun Yat-Sen University(The People’s Hospital of Guangxi Zhuang Autonomous Region East Division),Nanning 530000,China.)

机构地区：[1]广西壮族自治区人民医院颅脑肿瘤创伤功能神经外科,南宁530000 [2]中山大学附属第一医院广西医院(广西壮族自治区人民医院东院)神经外科

出　　处：《中国神经精神疾病杂志》2024年第8期470-475,共6页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的比较机器人辅助和数字减影血管造影(digital subtraction angiography,DSA)引导经皮穿刺三叉神经球囊压迫(percutaneous balloon compression,PBC)术两种术式的优缺点。方法回顾性分析2021年9月至2024年2月在一个中心连续开展的所有机器人辅助和DSA引导PBC术患者的临床资料85例(机器人组28例,DSA组57例),对比两组患者的一次穿刺成功率、视觉模拟评分(visual analogue scale,VAS)改善率、临床有效率、并发症率、手术时间及透视时间。结果两组在一次性穿刺成功率(96.43%vs.84.21%)、VAS评分改善率[88.89%(77.78%,100.00%)vs.88.89%(55.56%,100.00%)]、临床有效率(92.86%vs.94.74%)及并发症总发生率(35.71%vs.42.11%)上的差异无统计学意义(P>0.05)。机器人组手术时间[38.50(35.00,48.00)min]显著高于DSA组[19.00(15.00,25.50)min],机器人组透视时间[13.00(12.00,15.75)s]显著低于DSA组[194.00(152.50,259.50)s],两组平均手术及透视时间差异有统计学意义(P<0.05)。结论DSA引导手术在患者量大,追求效率的中心更有优势;而机器人辅助手术穿刺过程安全可控,患者射线暴露时间短,具有较高的临床应用和推广价值。Objective To compare the advantages of robot assisted and DSA guided PBC for the treatment of trigeminal neuralgia.Methods A retrospective clinical analysis was conducted on 85 patients(28 in robot group and 57 in DSA group)who underwent robot assisted and DSA guided PBC surgery in a same center from September 2021 to February 2024.The single puncture success rate,improvement rate of VAS score,clinical efficacy rate,incidence of complications,average surgical time and fluoroscopy time were compared between the two groups.Results There was no statistically significant difference between the two groups in terms of single puncture success rate(96.43%vs.84.21%),VAS improvement rate[88.9%(77.78%,100.00%)vs.88.89%(55.56%,100.00%)],clinical effective rate(92.86%vs.94.74%),and total incidence of complications(35.09%vs.42.11%)(P>0.05).The average surgical time was significantly higher in the robot group[38.50(35.00,48.00)min]than the DSA group[19.00(15.00,25.50)min],and the average fluoroscopy time in the robot group[13.00(12.00,15.75)s]was significantly lower than the DSA group[194.00(152.50,259.50)s].The difference in average surgical and fluoroscopy time between the two groups was statistically significant(P<0.05).Conclusion DSA guided surgery has more advantages in centers with a large number of patients and a pursuit of efficiency.The robot assisted surgical puncture process is safe and controllable and patient radiation exposure time is short,thereby having high clinical application and promotion value.

关 键 词：机器人 数字减影血管造影 经皮穿刺球囊压迫术 三叉神经痛 对比分析 

分 类 号：R651[医药卫生—外科学]