3D打印导航模板在圆孔外口三叉神经第二支射频治疗中的应用

发布时间：2018-04-03 12:24

  本文选题：三叉神经痛　切入点：D打印　出处：《临床麻醉学杂志》2017年03期

【摘要】：目的评估3D打印导航模板在圆孔入路三叉神经第二支射频热凝治疗中的有效性和准确性。方法选择原发性三叉神经第二支疼痛患者43例,男27例,女16例,年龄45~85岁,ASAⅠ或Ⅱ级,按照随机数字表法分为观察组(A组,n=21)和对照组(B组,n=22)。所有患者术前均行头颅CT三维重建,模拟穿刺并确定最佳穿刺方案。A组采用3D打印导板辅助经皮穿刺,B组在CT引导下常规穿刺,术中均经3D-CT影像及电刺激试验确认针尖位置后再行射频热凝治疗。记录患者一次穿刺成功例数、术中CT扫描次数、术中CT辐射量、手术时间、术后即刻疼痛NRS评分以及感觉减退、面部肿胀、角膜反射减弱、脑脊液漏等并发症发生情况。结果 A组一次性穿刺成功率明显高于B组(90.4%vs.22.7%),CT扫描次数明显少于B组[(1.1±0.3)次vs.(2.8±1.3)次],CT辐射量明显小于B组[(323.1±108.7)mGy*cm vs.(787.8±355.7)mGy*cm],手术时间明显短于B组[(15.3±5.5)min vs.(28.5±6.5)min](P0.05)。与术前比较,术后两组患者NRS评分明显降低[A组:(3.1±1.7)分vs.(8.5±0.7)分;B组:(3.1±1.5)分vs.(8.5±0.7)分](P0.05);两组患者NRS评分组间差异无统计学意义。所有患者均未发生严重并发症。结论在充分术前路径规划的基础上,3D打印导航模板能够明显提高圆孔穿刺精准性、安全性,提高三叉神经第二支射频治疗的效率与质量。
[Abstract]:Objective to evaluate the effectiveness and accuracy of 3D print navigation template in the treatment of the second branch of trigeminal nerve via the foramen roundus.Methods Forty-three patients with primary trigeminal nerve second branch pain, 27 males and 16 females, aged from 45 to 85 years old, were randomly divided into two groups: group A (n = 21) and control group B (n = 22).All the patients underwent CT 3D reconstruction before operation. The best puncture plan was confirmed. Group A was treated with 3D print guide plate assisted percutaneous puncture group B under the guidance of CT.Radiofrequency thermocoagulation was performed after 3D-CT imaging and electrical stimulation test were used to confirm the tip of the needle.The number of successful puncture, the number of CT scans, the amount of CT radiation, the time of operation, the NRS score of pain immediately after operation, the decrease of sensation, the swelling of the face, the weakening of corneal reflex and the cerebrospinal fluid leakage were recorded.缁撴灉 A缁勪竴娆℃，

本文编号：1705184