[目的]探究术中导航系统在脊柱侧弯矫形手术置钉中的临床应用效果。[方法]回顾性分析本院2015年7月—2018年7月手术治疗的脊柱侧弯40例患者的临床资料,依据术前医患沟通结果,21例采用术中三维即时导航系统辅助置钉(导航组),19例采用传...[目的]探究术中导航系统在脊柱侧弯矫形手术置钉中的临床应用效果。[方法]回顾性分析本院2015年7月—2018年7月手术治疗的脊柱侧弯40例患者的临床资料,依据术前医患沟通结果,21例采用术中三维即时导航系统辅助置钉(导航组),19例采用传统徒手方法置钉(徒手组)。比较两组围手术期、随访及影像资料。[结果]所有患者均顺利手术,无严重术中并发症。导航组置钉准确度[A/B/C/D/E,(221/8/5/0/0) vs (174/19/12/7/0), P<0.001]、手术时间[(43.7±12.2) min vs (65.4±19.7) min, P<0.001]、术中出血量[(623.2±40.5) ml vs (1 024.3±38.3) ml, P<0.001]、单钉置入时间[(2.2±1.3) min vs (5.1±2.4) min, P<0.001]均显著优于徒手组,但两组间下地行走时间、住院时间差异无统计学意义(P>0.05)。40例患者随访12~24个月,平均(18.2±4.6)个月,随时间推移,两组患者VAS评分及ODI均显著下降(P<0.05)。相应时间点,两组间VAS及ODI评分的差异均无统计学意义(P>0.05);两组患者均未出现后期畸形加重,均无翻修手术等并发症。影像方面,与术前相比,术后2周及末次随访两组的主弯Cobb角、后凸Cobb角、C7PL-CSVL及SVA均显著改善(P<0.05);相应时间点,两组间上述影像测量指标比较均无明显差异(P>0.05)。[结论]术中即时三维导航系统的应用使脊柱侧弯矫正手术置钉更加准确、快速,降低了手术风险,临床效果显著。展开更多
The tropospheric delay is one of the main error sources for radio navigation technologies and other ground-or space-based earth observation systems. In this paper, the spatial and temporal variations of the zenith tro...The tropospheric delay is one of the main error sources for radio navigation technologies and other ground-or space-based earth observation systems. In this paper, the spatial and temporal variations of the zenith tropospheric delay (ZTD), especially their dependence on altitude over China region, are analyzed using ECMWF (European Centre for Medium-Range Weather Forecast) pressure-level atmospheric data in 2004 and the ZTD series in 1999-2007 measured at 28 GPS stations from the Crustal Movement Observation Network of China (CMONC). A new tropospheric delay correction model (SHAO) is derived and a regional realization of this model for China region named SHAO-C is established. In SHAO-C model, ZTD is modeled directly by a cosine function together with an initial value and an amplitude at a reference height in each grid, and the variation of ZTD along altitude is fitted with a second-order polynomial. The coefficients of SHAO-C are generated using the meteorology data in China area and given at two degree latitude and longitude interval, featuring regional characteristics in order to facilitate a wide range of navigation and other surveying applications in and around China. Compared with the EGNOS (European Geostationary Navigation Overlay Service) model, which has been used globally and recommended by the European Union Wide Area Augmentation System, the ZTD prediction (in form of spatial and temporal projection) accuracy of the SHAO-C model is significantly improved over China region, especially at stations of higher altitudes. The reasons for the improvement are: (1) the reference altitude of SHAO-C parameters are given at the average height of each grid, and (2) more detailed description of complicated terrain variations in China is incorporated in the model. Therefore, the accumulated error at higher altitude can be reduced considerably. In contrast, the ZTD has to be calculated from the mean sea level with EGNOS and other models. Compared with the direct estimation of ZTD from the 28 GPS stations, the accuracy of the derived ZTD using the SHAO-C model can be improved by 60.5% averagely compared with the EGNOS model. The overall bias and rms are 2.0 and 4.5 cm, respectively, which should be sufficient to satisfy the requirements of most GNSS navigation or positioning applications in terms of the tropospheric delay correction.展开更多
文摘[目的]探究术中导航系统在脊柱侧弯矫形手术置钉中的临床应用效果。[方法]回顾性分析本院2015年7月—2018年7月手术治疗的脊柱侧弯40例患者的临床资料,依据术前医患沟通结果,21例采用术中三维即时导航系统辅助置钉(导航组),19例采用传统徒手方法置钉(徒手组)。比较两组围手术期、随访及影像资料。[结果]所有患者均顺利手术,无严重术中并发症。导航组置钉准确度[A/B/C/D/E,(221/8/5/0/0) vs (174/19/12/7/0), P<0.001]、手术时间[(43.7±12.2) min vs (65.4±19.7) min, P<0.001]、术中出血量[(623.2±40.5) ml vs (1 024.3±38.3) ml, P<0.001]、单钉置入时间[(2.2±1.3) min vs (5.1±2.4) min, P<0.001]均显著优于徒手组,但两组间下地行走时间、住院时间差异无统计学意义(P>0.05)。40例患者随访12~24个月,平均(18.2±4.6)个月,随时间推移,两组患者VAS评分及ODI均显著下降(P<0.05)。相应时间点,两组间VAS及ODI评分的差异均无统计学意义(P>0.05);两组患者均未出现后期畸形加重,均无翻修手术等并发症。影像方面,与术前相比,术后2周及末次随访两组的主弯Cobb角、后凸Cobb角、C7PL-CSVL及SVA均显著改善(P<0.05);相应时间点,两组间上述影像测量指标比较均无明显差异(P>0.05)。[结论]术中即时三维导航系统的应用使脊柱侧弯矫正手术置钉更加准确、快速,降低了手术风险,临床效果显著。
基金supported by the National Natural Science Foundation of China (Grant No.10603011 and 41174023)the National High Technology Research and Development Program of China (Grant No.2009AA12Z307)+2 种基金Science and Technology Commission of Shanghai Municipality (Grant Nos.05QMX1462 and 08ZR1422400)the Youth Foundation of Knowledge Innovation Project of the Chinese Academy of SciencesShanghai Astronomical Observatory (Grant No.5120090304)
文摘The tropospheric delay is one of the main error sources for radio navigation technologies and other ground-or space-based earth observation systems. In this paper, the spatial and temporal variations of the zenith tropospheric delay (ZTD), especially their dependence on altitude over China region, are analyzed using ECMWF (European Centre for Medium-Range Weather Forecast) pressure-level atmospheric data in 2004 and the ZTD series in 1999-2007 measured at 28 GPS stations from the Crustal Movement Observation Network of China (CMONC). A new tropospheric delay correction model (SHAO) is derived and a regional realization of this model for China region named SHAO-C is established. In SHAO-C model, ZTD is modeled directly by a cosine function together with an initial value and an amplitude at a reference height in each grid, and the variation of ZTD along altitude is fitted with a second-order polynomial. The coefficients of SHAO-C are generated using the meteorology data in China area and given at two degree latitude and longitude interval, featuring regional characteristics in order to facilitate a wide range of navigation and other surveying applications in and around China. Compared with the EGNOS (European Geostationary Navigation Overlay Service) model, which has been used globally and recommended by the European Union Wide Area Augmentation System, the ZTD prediction (in form of spatial and temporal projection) accuracy of the SHAO-C model is significantly improved over China region, especially at stations of higher altitudes. The reasons for the improvement are: (1) the reference altitude of SHAO-C parameters are given at the average height of each grid, and (2) more detailed description of complicated terrain variations in China is incorporated in the model. Therefore, the accumulated error at higher altitude can be reduced considerably. In contrast, the ZTD has to be calculated from the mean sea level with EGNOS and other models. Compared with the direct estimation of ZTD from the 28 GPS stations, the accuracy of the derived ZTD using the SHAO-C model can be improved by 60.5% averagely compared with the EGNOS model. The overall bias and rms are 2.0 and 4.5 cm, respectively, which should be sufficient to satisfy the requirements of most GNSS navigation or positioning applications in terms of the tropospheric delay correction.
