基于电磁跟踪的经数字减影血管造影手术导航

Medical surgical navigation through DSA using electromagnetic tracking system

目的为满足介入手术和微创手术中更精准的手术导航需求,采用Aurora电磁跟踪技术辅助手术导航,通过与各种手术器械自由组合,进一步解决手术中遇到的各种难题。方法采用Aurora电磁跟踪系统,与含有金属材料的医疗手术环境相匹配,利用电磁跟踪系统白带的控制软件,使用其配备二次开发包的VC编程语言编写一套适合临床手术导航的实时显示系统,并在医院不同的医学手术导航应用中进行性能测试和对比实验,测量跟踪系统的精确程度,统计各种手术器械分别对应不同手术应用的对照表。结果在介入手术中,随机选取160名冠状动脉造影患者,其中80名采用经数字减影血管造影(DSA)下电磁跟踪作为实验组,80名只使用DSA辅助作为对照组,结果发现实验组造影剂用量明显减少,操作时间明显缩短,介入手术操作可控度的成功率从95%提高到99%。结论通过对比实验,证明Aurora电磁跟踪技术明显提高了手术的定位精度,导航精度的平均值小于2 mm,在介入手术和微创手术方面,可以大大减轻病人痛苦,降低医疗风险,保障医疗安全,提升医院手术技术水平。

Objective In order to meet the needs of more precise surgical navigation during interventional procedures and minimally invasive surgery, Aurora electromagnetic tracking technology-assisted surgical navigation with free combination of various surgical instruments was tested, trying to further solve problems encountered in surgery. Methods Aurora electromagnetic tracking system was used to match the medical surgical environment with metal-containing material. The built-in control software in this electromagnetic tracking system, which was equipped with the software development kit, was used to write a set of VC programming language suitable for realtime display of clinical surgical navigation system, and relative performance tests and comparative experiments were conducted for different medical surgical navigation application in the hospital to measure the precision degree of the tracking system, as well as the statistics of various surgical instruments corresponding to the application in different surgeries. Results 160 patients in interventional surgery with coronary angiography were randomly selected, 80 patients treated by digital subtraction angiography（DSA） with electromagnetic tracking systems as the experimental group, and 80 patients by DSA only as the control group. It was found out that with obviously less operating time, the amount of contrast agent was significantly reduced in the experimental group, and the degree of controllability for interventional surgical procedure was increased from 95% success rate to 99%. Conclusions The comparative experiments proved that Aurora electromagnetic tracking technology could significantly improve the accuracy in surgery, with the mean value of navigation less than 2 mm. In terms of interventional procedures and minimally invasive surgery, this electromagnetic tracking technology can greatly relieve patients＇suffering and reduce medical risks to make medical care safer, and enhance the surgical technology level in hospital.