Puncture path

  • 文章类型: Journal Article
    背景:双椎弓根/单椎弓根椎体后凸成形术是OVCF的常用治疗方法,也没有研究表明哪个对AVCF更有利。目的探讨BPKP或UPKP治疗AVCF的临床疗效。
    方法:回顾性分析PKP治疗AVCF患者的临床资料。根据手术方式分为两组。一般人口统计数据,围手术期并发症,记录两组手术相关的一般资料.术前、术后椎体高度差,椎体局部Cobb角,对两组的腰椎疼痛VAS评分和腰椎JOA评分进行统计.术前比较上述数据,术后和两组之间。
    结果:成功纳入25例AVCF患者,均随访至少12个月,随访期间无并发症。BPKP组10例,UPKP组15例,两组一般资料差异无统计学意义。术后12个月BPKP组患者的VAS评分低于UPKP组,差异有统计学意义,两组在其他随访时间点无统计学差异。在BPKP组中,80%的患者具有对称且更均匀的骨水泥分散。UPKP组50%的患者存在骨水泥横向分布和骨水泥分布不均,两组间骨水泥分布差异有统计学意义。
    结论:对于AVCF的治疗,两种手术方式的临床疗效基本相同。在BPKP组中,水泥的分布更加对称且均匀扩散,长期随访中临床疗效VAS评分较低。建议将双椎弓根椎体后凸成形术用于AVCF的治疗。
    XZXY-LJ-20161208-047。
    BACKGROUND: Bipedicular/unipedicular percutaneous kyphoplasty are common treatments for OVCF, and there are no studies to show which is more beneficial for AVCF. The purpose of this study was to investigate the clinical efficacy of BPKP or UPKP in the treatment of AVCF.
    METHODS: The clinical data of AVCF patients treated by PKP were retrospectively analyzed. They were divided into two groups according to the surgical approach. General demographic data, perioperative complications, and general information related to surgery were recorded for both groups. The preoperative and postoperative vertebral height difference, vertebral local Cobb angle, lumbar pain VAS score and lumbar JOA score were counted for both groups. The above data were compared preoperatively, postoperatively and between the two groups.
    RESULTS: 25 patients with AVCF were successfully included and all were followed up for at least 12 months, with no complications during the follow-up period. 10 patients in the BPKP group and 15 patients in the UPKP group, with no statistically significant differences in general information between the two groups. The VAS scores of patients in the BPKP group were lower than those in the UPKP group at 12 months after surgery, and the differences were statistically significant, and there were no statistically significant differences between the two groups at other follow-up time points. In the BPKP group, 80% of patients had symmetrical and more homogeneous bone cement dispersion. 50% of patients in the UPKP group had a lateral distribution of bone cement and uneven bone cement distribution, and the difference in bone cement distribution between the two groups was statistically significant.
    CONCLUSIONS: For the treatment of AVCF, the clinical efficacy of both surgical approaches is basically the same. The distribution of cement is more symmetrical and uniformly diffused in the BPKP group, and the clinical efficacy VAS score is lower in the long-term follow-up. Bipedicular percutaneous kyphoplasty is recommended for the treatment of AVCF.
    UNASSIGNED: XZXY-LJ-20161208-047.
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  • 文章类型: Journal Article
    目的:射频消融(RFA)是治疗肝脏肿瘤的有效方法。术前路径规划,在RFA治疗中起着至关重要的作用,需要医生有丰富的经验和能力。具体来说,正确和高度活跃的术前路径规划应确保整个穿刺过程的安全,肿瘤的完全消融和对健康组织的最小损伤。
    方法:在本文中,提出了一种高安全性的肝肿瘤自动多次穿刺路径规划方法,其中消融次数的优化,穿刺号,研究了受临床综合约束的目标位置和穿刺点位置。特别是,同时考虑穿刺路径的安全性和消融椭圆体的分布。详细讨论了各个约束条件对整个穿刺过程安全性的影响。在此基础上,通过简化计算数据和优化变量,该规划方法的效率明显提高。此外,比较并总结了该方法对大型和小型肿瘤的性能和适应性。
    结果:对来自7例的10个具有各种几何特征的肝肿瘤进行了评估。测试结果表明,平均路径规划时间和平均消融效率分别为41.4s和60.19%,分别。对于不同大小的肿瘤,从所提出的方法获得的规划结果具有相似的健康组织覆盖率。通过医生的临床评估,规划结果满足肝脏肿瘤RFA的需要。
    结论:所提出的方法可以在RFA规划中提供合理的穿刺路径,有利于保证肝脏肿瘤消融的安全性和高效性。
    OBJECTIVE: Radiofrequency ablation (RFA) is an effective method for the treatment of liver tumors. Preoperative path planning, which plays a crucial role in RFA treatment, requires doctors to have significant experience and ability. Specifically, correct and highly active preoperative path planning should ensure the safety of the whole puncturing process, complete ablation of tumors and minimal damage to healthy tissues.
    METHODS: In this paper, a high-security automatic multiple puncture path planning method for liver tumors is proposed, in which the optimization of the ablation number, puncture number, target positions and puncture point positions subject to comprehensive clinical constraints are studied. In particular, both the safety of the puncture path and the distribution of ablation ellipsoids are taken into consideration. The influence of each constraint on the safety of the whole puncturing process is discussed in detail. On this basis, the efficiency of the planning method is obviously improved by simplifying the computational data and optimized variables. In addition, the performance and adaptability of the proposed method to large and small tumors are compared and summarized.
    RESULTS: The proposed method is evaluated on 10 liver tumors of various geometric characteristics from 7 cases. The test results show that the average path planning time and average ablation efficiency are 41.4 s and 60.19%, respectively. For tumors of different sizes, the planning results obtained from the proposed method have similar healthy tissue coverage. Through the clinical evaluation of doctors, the planning results meet the needs of RFA for liver tumors.
    CONCLUSIONS: The proposed method can provide reasonable puncture paths in RFA planning, which is beneficial to ensure the safety and efficiency of liver tumor ablation.
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