CT引导下经皮腰椎间盘穿刺新型自制三维定位仪的研制与临床应用

Development and clinical application of a self-made three-dimensional localizer in CT-guided percutaneous lumbar disc puncture

目的研制新型三维定位仪应用于CT引导下经皮腰椎间盘穿刺,提高穿刺的准确率和安全性。方法参考CT pinpoint激光系统高精度测量的特点,根据立体几何学原理,研制新型三维定位仪。对183例186个椎间盘(应用组)应用自制三维定位仪进行辅助定位穿刺,并与未使用定位仪辅助、单纯CT定位穿刺的186个椎间盘(对照组)进行比较,分析两组的穿刺成功率和优良率。结果应用组穿刺成功率为98.92%,优良率为90.32%;对照组穿刺成功率为96.77%,优良率为49.46%。两组间穿刺优良率差异有统计学意义(P<0.001)。结论该新型自制三维定位仪应用方便,可有效提高CT引导下经皮腰椎间盘穿刺的准确率和安全性,值得临床推广应用。

Objective To design a new three-dimensional localizer for percutaneous lumbar disc puncture,which can improve the accuracy and safety.Methods According to geometric theory and parameters that obtained with CT pinpoint laser-guided scan system,a new three-dimensional localizer was designed and developed.Totally 183 patients with 186 lumbar discs （research group） were operated with assistance of the localizer,while other 186 lumbar discs without the localizer were selected as the control group.The successful rate and the excellent rate of puncture were analyzed.Results The total successful puncture rate and the excellent rate of research group was 98.92% and 90.32%,as well as those of control group was 96.77% and 49.46%,respectively.Statistical difference of the excellent puncture rate was found between the two groups （P0.001）.Conclusion The new three-dimensional localizer can improve the accuracy of orientation and the safety of operation in percutaneous lumbar discs puncture under guidance of CT efficiently and conveniently.