机器人辅助超声引导下经皮穿刺的体外实验研究  

Ultrasound-guided robot-assisted percutaneous puncture:an experimental study

作　　者：孙佳丽 金琳 沈崔琴 陈晴晴 林艳萍[4] 李朝军 徐栋[1] Sun Jiali;Jin Lin;Shen Cuiqin;Chen Qingqing;Lin Yanping;Li Zhaojun;Xu Dong(Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Ultrasound,Jiading Branch of Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201803,China;Department of Ultrasound,Guanghua Hospital Affiliated to Shanghai University among Traditional Chinese Medicine,Shanghai 200052,China;School of Mechanical Engineering,Shanghai Jiao Tong University,Shanghai 200240,China;Department of Ultrasound,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200080,China)

机构地区：[1]浙江中医药大学,杭州310053 [2]海市第一人民医院嘉定医院超声科,201803 [3]上3.上海中医药大学附属光华医院超声科,200052 [4]上海交通大学机械与动力工程学院,200240 [5]上海交通大学医学院附属第一人民医院超声科,200080

出　　处：《中华医学超声杂志（电子版）》2024年第9期884-889,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：上海市自然科学基金(21ZR1451400);上海市卫生健康委员会卫生行业临床研究专项(202240235);上海市嘉定区卫生和计划生育委员会基金(2021-KY-10);上海市嘉定区江桥医院“科技计划”项目(202127A)。

摘　　要：目的评估不同穿刺经验操作者在穿刺机器人辅助超声引导下经皮穿刺体外模型实验中的准确性和可行性。方法2位不同年资的医师分别通过穿刺机器人辅助系统和徒手对甲状腺结节体模中的目标进行穿刺实验,每人分别做10次穿刺。采用t检验对比2种穿刺方式的穿刺针尖定位误差、针轴角度误差以及操作时间的差异,并采用组内相关系数(ICC)分析不同年资医师使用穿刺机器人辅助系统进行穿刺实验的一致性。结果机器人辅助比徒手穿刺精准度更高,但操作时间更长,两者针尖定位误差为(0.62±0.26)mm vs(1.29±0.38)mm,针轴角度误差为(1.04±0.63)°vs(2.01±0.86)°,平均操作时间为(26.45±12.44)s vs(20.58±9.86)s,差异均具有统计学意义(t=9.187、P<0.001;t=3.409、P=0.003;t=-2.289、P=0.034)。不同经验的操作者利用机器人辅助系统穿刺,在针尖定位误差和操作时间上均具有极佳的一致性[ICC(95%可信区间)=0.783(0.126~0.946)、0.903(0.610~0.876)]。结论与徒手穿刺相比,使用机器人辅助系统穿刺具有更高的准确性及稳定性,但使用机器人辅助系统增加了操作时间。Objective To assess the accuracy and feasibility of ultrasound-guided robot-assisted percutaneous puncture.Methods Two physicians with different years of experience conducted ultrasound-guided puncture experiments on thyroid nodule phantoms using both the puncture robot-assisted system and manual puncture,each for 10 times.The puncture needle positioning error,directional error,and total operation time were recorded.Additionally,the consistency among physicians with different experience levels when using the puncture robot-assisted system for puncture was assessed.Results The robot-assisted group demonstrated higher puncture accuracy than the manual group,but with longer operation times.The average needle tip error in the robot-assisted group versus the manual group was(0.62±0.26)mm vs(1.29±0.38)mm,the average needle axis angle error was(1.04±0.63)°vs(2.01±0.86)°,and the average operation time was(26.45±12.44)s vs(20.58±9.86)s;the differences were statistically significant between the two groups(t=9.187,P<0.001;t=3.409,P=0.003;t=-2.289,P=0.034).Operators with different experiences using the robot-assisted system for puncture showed good consistency in needle tip error and operation time,with intraclass correlation coefficient(95%confidence interval)values of 0.783(0.126-0.946)and 0.903(0.610-0.876),respectively(P<0.05).Conclusion Compared to manual puncture,the robot-assisted system exhibits higher accuracy and stability in ultrasound-guided thyroid nodule puncture procedures.However,the use of the robot-assisted system increases the operation time.

关 键 词：超声检查 超声引导经皮穿刺 手术机器人 微创 

分 类 号：R445.1[医药卫生—影像医学与核医学] TP242[医药卫生—诊断学]