数字化3D打印导板导航技术在三叉神经半月神经节射频热凝术中的应用  

Application of Digital 3D Printing Guide Navigation Technology in Percutaneous Radiofre-quency Thermocoagulation of Trigeminal Semilunar Ganglion

作　　者：富饶 裴延军 欧益谊 陈燕枝 贺道华 杨红军 FU Rao;PEI Yanjun;OU Yiyi;CHEN Yanzhi;HE Daohua;YANG Hongjun(Department of Neurology,Hospital of Southern University of Science and Technology,Innovation Center,Guangdong Shenzhen 518000,China)

机构地区：[1]南方科技大学医院神经内科/创新中心,广东深圳518000

出　　处：《神经损伤与功能重建》2024年第12期715-719,共5页Neural Injury and Functional Reconstruction

基　　金：2021年深圳市南山区科技计划项目(数字化3D打印导板导航技术在神经病理性疼痛介入治疗中的临床应用研究,No.NS2021027);深科技创新(基2020N394慢性疼痛行为认知异常的神经机制及评估方法的研究,No.[2020]230号)。

摘　　要：目的:评估3D打印导板导航技术应用于三叉神经半月神经节射频热凝术(PRT)治疗三叉神经痛的临床疗效。方法:选取我院收治的原发性三叉神经痛、且有PRT指征的患者35例为研究对象,随机分为对照组(15例)和观察组(20例)。对照组在数字减影血管造影(DSA)引导下行PRT,观察组用3D打印导板导航辅助PRT。比较2组的一次穿刺成功率,经皮穿刺到达靶点所需时间,手术时长,DSA扫描次数,患者术中不适,术后即刻、3 d、30 d的疼痛数字评分法(NRS)评分,术后1、3、6个月疗效评估,手术满意度,不良反应及并发症发生率。结果:观察组的一次穿刺成功率高于对照组(P<0.01);观察组的穿刺到达靶点时间、手术时长、DSA扫描次数、术中不适、术后不良反应、术后即刻、术后3 d NRS评分均低于对照组(P<0.01);观察组术后不良反应发生率明显低于对照组(P<0.01)。2组术后1个月的NRS评分、术后1、3、6月疗效评估、满意度、二次手术差异无统计学意义(P>0.05)。结论:3D打印导板导航技术辅助PRT有助于增加三叉神经痛手术的高效性、安全性,减少疼痛及不良反应,有良好临床应用前景。Objective:To evaluate the clinical efficacy of 3D printed guide plate navigation technology in the application of percutaneous radiofrequency thermocoagulation(PRT)for the treatment of trigeminal neuralgia.Methods:A total of 35 patients with primary trigeminal neuralgia and indications for PRT treated in our hospital were selected as research subjects and randomly divided into a control group(15 cases)and an observation group(20 cases).The control group underwent PRT guided by digital subtraction angiography(DSA),while the observation group used 3D printed guide plate navigation-assisted PRT.The two groups were compared in terms of the success rate of one-time puncture,the time required for percutaneous puncture to reach the target,operation duration,number of DSA scans,intraoperative discomfort in patients,Numerical Rating Scale(NRS)scores immediately after surgery,at 3 days,and at 30 days post-surgery,therapeutic effect evaluation at 1,3,and 6months after surgery,surgical satisfaction,adverse reactions,and the incidence of complications.Results:The success rate of one-time puncture in the observation group was higher than that in the control group(P<0.01);the observation group had lower times for puncture to reach the target,operation duration,number of DSA scans,intraoperative discomfort,adverse reactions after surgery,and NRS scores immediately after surgery and at 3 days post-surgery than the control group(P<0.01);the incidence of adverse reactions after surgery in the observation group was significantly lower than that in the control group(P<0.01).There was no statistically significant difference between the two groups in NRS scores at 1 month after surgery,therapeutic effect evaluation at1,3,and 6 months after surgery,satisfaction,and secondary surgeries(P>0.05).Conclusion:3D printed guide plate navigation technology-assisted PRT helps increase the efficiency and safety of the surgery for trigeminal neuralgia,reduce pain and adverse reactions,and has a good prospect for clinical application.

关 键 词：3D打印 导板导航 经皮穿刺三叉神经半月神经节射频热凝术 三叉神经痛 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学] R745