摘要
背景:研究报道经皮椎体成形术的放射暴露剂量是其他脊柱手术的10倍。单纯C型臂依据二维图像不能提供更多的伤椎信息,在引导术中定位穿刺过程中存在技术缺陷,对医患双方均存在安全隐患。因此,如何提高定位精准度,减少或避免放射剂量的暴露是目前达成的一致共识。目的:评价一种人工智能激光导引系统减少椎体成形术定位时间与放射暴露剂量的有效性。方法:纳入86例骨质疏松性椎体压缩骨折椎体成形患者,随机分为2组。试验组43例在人工智能激光定位系统辅助下进行体表定位,对照组43例采用常规C臂透视进行体表定位。对透视次数、辐射剂量和定位穿刺时间进行记录,采用Hitachi-Aloka辐射剂量记录仪对辐射剂量进行记录。结果与结论:①相比对照组,试验组定位透视次数、穿刺透视次数、放射剂量更少,定位穿刺时间更短(P<0.001);②试验组穿刺精准度较对照组提高了65%;③2组患者均无聚甲基丙烯酸甲酯溢入椎管、胸腹腔,无肺栓塞、感染发生;④提示该人工智能激光定位系统可提高了C型臂在椎体成形术中定位的精准度,有效减少椎体定位的透视次数、放射暴露剂量,缩短了定位穿刺时间。该系统简单易学,使用过程中应防止患者躯体移位。
BACKGROUND: Studies have reported that the radiation exposure dose of percutaneous vertebroplasty is 10 times that of other spinal operations. According to the two-dimensional image, the C-arm alone cannot provide more information about the injured vertebrae. There are technical defects in the process of positioning puncture during the guide operation, which has potential safety risks for both doctors and patients. Therefore,how to improve the positioning accuracy and reduce or avoid the exposure of radiation dose is a consensus. OBJECTIVE: To evaluate the effectiveness of an artificial intelligent laser location system in reducing the location time and radiation dose in vertebroplasty procedures. METHODS: Eighty-six cases with osteoporotic vertebral compression fracture were randomly divided into two groups. Forty-three cases in the trial group were located on the body surface with C-arm fluoroscopy assisted by the artificial intelligent laser location system, and the remaining 43 cases in the control group were treated with regular C-arm fluoroscopy alone. For each procedure, radioscopy frequency, radiation dose and location puncture time were recorded. The radiation dose was documented using a Hitachi-Aloka Medical external dosimeter. RESULTS AND CONCLUSION:(1) Location radioscopy frequency, radioscopy frequency of puncture, and total radiation dose were less, and the mean procedure time was shorter in the trial group compared with the control group(P<0.001).(2) The puncture accuracy of the trial group was 65% higher than that of the control group.(3) In both groups, no polymethyl methacrylate leakage into the spinal canal, chest or abdominal cavity, no pulmonary embolism or infection occurred.(4) It is concluded that the C-arm assisted artificial intelligent laser location system applied in percutaneous vertebroplasty improves the accuracy of location in percutaneous vertebroplasty, effectively reduces the radioscopy frequency and radiation exposure dose, and shortens the location puncture time. This system is simple and easy to learn. During the procedure, the patient’s body should be prevented from shifting.
作者
王秀廷
李嗣生
孙健
张根源
刘法银
张金涛
Wang Xiuting;Li Sisheng;Sun Jian;Zhang Genyuan;Liu Fayin;Zhang Jintao(Department of Spinal Surgery,Zibo Seventh People’s Hospital,Zibo 255040,Shandong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第33期5295-5299,共5页
Chinese Journal of Tissue Engineering Research
基金
2020年度山东省自然科学基金项目(第一批)(ZR201911020070),项目负责人:李嗣生。
关键词
骨
骨质疏松
人工智能
激光
C型臂
椎体成形术
定位
放射
透视
bone
osteoporosis
artificial intelligence
laser
C-arm
vertebroplasty
localization
radiation
fluoroscopy
