發(fā)布時間：2018-04-03 12:24

  本文選題：三叉神經(jīng)痛　切入點：D打印　出處：《臨床麻醉學雜志》2017年03期

【摘要】：目的評估3D打印導航模板在圓孔入路三叉神經(jīng)第二支射頻熱凝治療中的有效性和準確性。方法選擇原發(fā)性三叉神經(jīng)第二支疼痛患者43例,男27例,女16例,年齡45~85歲,ASAⅠ或Ⅱ級,按照隨機數(shù)字表法分為觀察組(A組,n=21)和對照組(B組,n=22)。所有患者術前均行頭顱CT三維重建,模擬穿刺并確定最佳穿刺方案。A組采用3D打印導板輔助經(jīng)皮穿刺,B組在CT引導下常規(guī)穿刺,術中均經(jīng)3D-CT影像及電刺激試驗確認針尖位置后再行射頻熱凝治療。記錄患者一次穿刺成功例數(shù)、術中CT掃描次數(shù)、術中CT輻射量、手術時間、術后即刻疼痛NRS評分以及感覺減退、面部腫脹、角膜反射減弱、腦脊液漏等并發(fā)癥發(fā)生情況。結果 A組一次性穿刺成功率明顯高于B組(90.4%vs.22.7%),CT掃描次數(shù)明顯少于B組[(1.1±0.3)次vs.(2.8±1.3)次],CT輻射量明顯小于B組[(323.1±108.7)mGy*cm vs.(787.8±355.7)mGy*cm],手術時間明顯短于B組[(15.3±5.5)min vs.(28.5±6.5)min](P0.05)。與術前比較,術后兩組患者NRS評分明顯降低[A組:(3.1±1.7)分vs.(8.5±0.7)分;B組:(3.1±1.5)分vs.(8.5±0.7)分](P0.05);兩組患者NRS評分組間差異無統(tǒng)計學意義。所有患者均未發(fā)生嚴重并發(fā)癥。結論在充分術前路徑規(guī)劃的基礎上,3D打印導航模板能夠明顯提高圓孔穿刺精準性、安全性,提高三叉神經(jīng)第二支射頻治療的效率與質(zhì)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.緇撴灉 A緇勪竴嬈℃，

本文編號：1705184