3D打印个体化穿刺导板辅助经皮穿刺微球囊压迫术治疗原发性三叉神经痛
Safety and efficacy of percutaneous balloon compression assisted by a 3D printed personalized guide plate for patients with primary trigeminal neuralgia
詹维强 1姜士炜 1寿纪新2
作者信息
- 1. 464000 河南,信阳市中心医院院外科医学部神经外科
- 2. 450052 郑州,郑州大学第五附属医院神经外科
- 折叠
摘要
目的 探讨3D打印个体化穿刺导板辅助经皮穿刺微球囊压迫术(PBC)治疗原发性三叉神经痛(PTN)的可行性、安全性及疗效.方法 2019年1月至2023年6月前瞻性收集62例PTN,根据病人的意愿分为观察组(n=30)和对照组(n=32).观察组术前制作3D打印个体化穿刺导板,术中利用导板设计的穿刺角度和进针位点辅助穿刺,对照组术中利用经验性hartel路径穿刺.术中记录手术时间、卵圆孔穿刺时间、重复穿刺次数、移动X线照射次数;术后记视觉模拟量表(VAS)评分、并发症情况(面部麻木、咀嚼肌无力、口周疱疹、脑脊液渗漏等).结果 观察组手术时间(42 min;IQR:37～48 min)较对照组(49.5 min;IQR:41.5～53)明显缩短(P=0.003);观察组卵圆孔穿刺时间(7.5 min;IQR:5～9 min)较对照组(10.5 min;IQR:7～16 min)明显缩短(P=0.004);观察组术中穿刺次数(2次;IQR:2～3次)较对照组(3次;IQR:2～4次)明显减少(P=0.002);观察组组术中X线照射次数(5次;IQR:4～6次)较对照组(7次;IQR:5～8次)明显减少(P<0.001).术后两组VAS评分较术前均明显降低(P<0.05),但两组之间无统计学差异(P>0.05).两组术相关并发症发生率无统计学差异(P>0.05).结论 PBC治疗PTN时,相比传统的经验性穿刺,3D打印个体化穿刺导板辅助能达到相同的治疗效果,而且明显缩短手术时间、穿刺时间,明显减少穿刺次数及X线照射次数.
Abstract
Objective To investigate the feasibility,safety,and efficacy of 3D printing individualized guide plate assisted percutaneous balloon compression(PBC)for patients with primary trigeminal neuralgia(PTN).Methods Between January 2019 and June 2023,62 patients with PTN were prospectively collected and divided into an observation group(n=30)and a control group(n=32)according to the patient's preference.The 3D printing individualized puncture guide plate was prepared before surgery in the observation group,and the puncture angle and needle insertion site were assisted by the guide plate during surgery.The experience-based Hartel path for puncture was used during surgery in the control group.The surgical time,foramen ovale puncture time,number of repeated punctures and number of X-ray exposures were recorded during surgery.After surgery,the visual analog scale(VAS)score and complications(facial numbness,trismus,herpes zoster around the mouth,cerebrospinal fluid leakage,etc.)were recorded.Results The surgical time in the observation group(42 min;IQR:37～48 min)was significantly shorter than that(49.5 min;IQR:41.5～53 min)in the control group(P=0.003).The foramen ovale puncture time in the observation group(7.5 min;IQR:5～9 min)was significantly shorter than that(10.5 min;IQR:7～16 min)in the control group(P=0.004).The number of punctures in the observation group(2 times;IQR:2～3 times)was significantly reduced compared with that(3 times;IQR:2～4 times)in the control group(P=0.002).The number of X-ray exposures in the observation group(5 times;IQR:4～6 times)was significantly reduced compared with that(7 times;IQR:5～8 times)in the control group(P<0.001).The VAS scores in both groups were significantly lower after surtery than those before surgery(P<0.05),but there was no statistical difference between the two groups(P>0.05).There was no statistically significant difference in the incidence of procedure-related complications between the two groups(P>0.05).Conclusions Compared with traditional empirical puncture,3D printed individualized puncture guide plate can achieve the same therapeutic effect in PBC treatment of PTN,and significantly shorten the operation time,puncture time,and the number of punctures and X-ray exposures.
关键词
原发性三叉神经痛/经皮穿刺微球囊压迫术/3D打印个体化穿刺导板Key words
Primary trigeminal neuralgia/Percutaneous balloon compression/3D printed individualized puncture guide plate引用本文复制引用
基金项目
2022年信阳市重点研发与推广专项基金(20220057)
出版年
2024
NETL
NSTL
万方数据