混合现实技术在侧脑室穿刺外引流术中的应用
Application of mixed reality technology in external ventricular drainage
吕亚兵 1陈振波 1李晓辉 1张金玲 1陶山伟 1张智勇 1崔建飞 1姚佳丽 1姚庆和1
作者信息
- 1. 471000 河南洛阳,郑州大学附属洛阳中心医院神经外科
- 折叠
摘要
目的 探讨混合现实技术引导侧脑室外引流术(EVD)的可行性和临床价值.方法 2022年1月至2023年6月前瞻性连续收集需要行EVD的50例(脑出血23例,脑积水27例)为观察组,以2020年6月至2021年12月行传统EVD治疗的50例(脑出血26例,脑积水24例)为对照组.观察组术前将头颅CT、MRI的DICOM数据导入3D Slicer软件制定手术计划,然后将各模型文件利用浏览器导入头戴式混合现实全息影像设备,根据手术路径的全息投影引导操作.对照组术前根据CT影像制定手术计划,术中依据体表标志进行盲穿.结果 观察组50例均顺利完成手术.观察组引流管尖端与目标靶点的距离[(4.43±1.37)mm]较对照组[(10.41±3.42)mm]明显缩小(P<0.001).观察组穿刺精确性Kakarl分级1级47例(94.00%),2级3例(6.00%);对照组Ka-karl分级1级39例(78.00%),2级9例(18.00%),3级2例(4.00%);观察组穿刺精确性Kakarl分级明显优于对照组(P=0.048).观察组一次穿刺成功率(98.00%)与对照组(88.00%)无统计学差异(P=0.117).结论 混合现实技术可用于引导EVD,可以提高置管的精确性.
Abstract
Objective To explore the feasibility and clinical value of mixed reality technology in guiding external ventricular drainage(EVD).Methods Fifty patients(23 cases of cerebral hemorrhage,27 cases of hydrocephalus)who needed EVD were prospectively collected from January 2022 to June 2023(observation group),and 50 patients(26 cases of cerebral hemorrhage,24 cases of hydrocephalus)who underwent traditional EVD from June 2020 to December 2021 were selected as the control group.In the observation group,the DICOM data of head CT and MRI were imported into the 3D Slicer software for the surgical planning before operation,and then the model files were imported into the head-mounted mixed reality holographic imaging equipment using the browser to guide puncture according to the holographic projection of the surgical path.In the control group,the surgical plan was made according to the CT images before operation,and the blind puncture was performed according to the body surface marks during operation.Results All 50 patients in the observation group successfully completed the operation.The distance between the tip of the drainage tube and the target point in the observation group[(4.43±1.37)mm]was significantly smaller than that[(10.41±3.42)mm]in the control group(P<0.001).In the observation group,the puncture accuracy of Kakral grade 1 was achieved in 47 cases(94.00%),and grade 2 in 3 cases(6.00%).In the control group,the puncture accuracy of Kakral grade 1 was achieved in 39 cases(78.00%),grade 2 in 9 cases(18.00%),and grade 3 in 2 cases(4.00%).The puncture accuracy of Kakral grade in the observation group was significantly better than that in the control group(P=0.048).There was no statistically significant difference in the success rate of one puncture between the observation group(98.00%)and the control group(88.00%;P=0.117).Conclusions Mixed reality technology can be used to guide EVD,which can improve the accuracy of catheterization.
关键词
侧脑室穿刺外引流术/混合现实技术/可行性/临床价值Key words
External ventricular drainage(EVD)/Mixed reality technology/Feasibility/Clinical value引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210842)
出版年
2024
NETL
NSTL
万方数据