In-vitro laser alignment guidance system for minimally invasive intracranial hematoma cleaning operation and positioning method
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A technology of laser collimation and intracranial hematoma, applied in the direction of stereotaxic surgical instruments, etc., can solve the problems of complicated operation steps, rough methods, puncture errors, etc., and achieve the effect of increasing the surgical field, wide clinical application, and avoiding steric hindrance.
Active Publication Date: 2016-08-10
NANJING DRUM TOWER HOSPITAL
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[0004] Minimally invasive intracranial hematoma evacuation has a low clinical technical threshold and is a medical and health technology that is suitable and has been promoted at the grassroots level. However, the hematoma is located in the brain and cannot be directly observed with the naked eye. The commonly used head and face physiological body surface markers cannot meet the requirements of precise puncture. Require
Whether it is soft channel or hard channel puncture, hematoma location and needle insertion path are often assisted by cranial CT and square ruler, mainly relying on naked eyes and clinical experience. Complications such as severe tissue damage
The most clinically used method is to simulate the midsagittal plane of the skull with a flat plate and the front of the skull, and judge the vertical relationship between the puncture needle and the plane with the naked eye, as well as the relationship between the puncture needle and the collimated plane of CT examination. The method is rough and lacks scientificity.
The 2014 version of the technical specifications for minimally invasive puncture removal of intracranial hematoma introduced the technical method of using an auxiliary locator in the mode of external fixation to increase the positioning accuracy, but the operation steps are cumbersome, the equipment is complicated, the technical threshold is high, and there are contact locators. Increase the risk of intracranial infection rate, the actual clinical use rate is not high
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Embodiment 1
[0058] Patient Chen Moumou, female, 64 years old, was admitted to the hospital due to "sudden left limb weakness for three days". Previous history of hypertension. Physical examination: drowsiness, shallow left nasolabial fold, left tongue deviation, left limb muscle strength level 0, shallow hypoesthesia, and positive left Pap sign. Head CT in the outer hospital showed cerebral hemorrhage in the right basal ganglia. Diagnosis: hypertensive cerebral hemorrhage. After admission, minimally invasive puncture evacuation of intracranial hematoma was planned.
[0059] Preoperative cranial CT positioning shows a large amount of bleeding, and the midline structure is slightly shifted, such as Figure 8 shown.
[0060] Intracranial hematoma was minimally invasively evacuated, and the extracorporeal laser alignment and guidance system was reexamined immediately after puncture, and the positioning was accurate. The puncture needle reached the center of the hematoma, that is, the punc...
Embodiment 2
[0066] Patient Zhang Moumou, female, 77 years old, was admitted to the hospital due to "sudden right limb weakness for one day". Previous history of hypertension. Head CT showed: cerebral hemorrhage in the left frontotemporal lobe. Diagnosis: spontaneous cerebral hemorrhage. After admission, minimally invasive puncture evacuation of intracranial hematoma was performed.
[0067] Simple CT image positioning, no extracorporeal laser alignment and guidance system for minimally invasive removal of intracranial hematoma.
[0068] CT images can be reviewed after surgery Figure 12 As shown, the CT scan after 6 days is as follows Figure 13 As shown, it indicates that the puncture point is offset, the puncture site does not reach the target point, the drainage of the hematoma is not smooth, and the treatment effect is not good.
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Abstract
The invention discloses a non-contact positioning auxiliary device used for the minimally invasive intracranial hematoma cleaning operation. The non-contact positioning auxiliary device comprises a fixed rack, a right-angle connecting rod, a right-angle connecting rod fixing shaft, a height adjusting device, a horizontal telescopic boom, a vertical telescopic boom, a vertical-direction laser alignment device and a horizontal-direction laser alignment device, wherein the far end of the horizontal telescopic boom is provided with the vertical-direction laser alignment device, the vertical-direction sector-shaped laser face emitted by the vertical-direction laser alignment device is vertical to the long shaft of the horizontal telescopic boom, a light source points to the downward direction, and a guiding datum line mark is provided; the far end of the vertical telescopic boom is provided with the horizontal-direction laser alignment device, the sector-shaped laser face emitted by the horizontal-direction laser alignment device can rotate along the optical axis of the laser through a rotation adjusting mechanism, and the sector-shaped laser face emitted by the horizontal-direction laser alignment device is enabled to be always vertical to the vertical-direction sector-shaped laser face through the right-angle-shaped adjusting booms. According to the non-contact positioning auxiliary device, the non-frame cantilever laser alignment guide technology is adopted, therefore, the puncture needle is accurately guided continuously during the operation; the non-contact design increases the visual operative field, and thus the steric hindrance in the puncture process is avoided.
Description
technical field [0001] The invention belongs to the technical field of medical equipment, and relates to a non-contact precise guiding puncture device for intracranial hematoma, in particular to an extracorporeal laser alignment and guiding system and positioning method for minimally invasive removal of intracranial hematoma. Background technique [0002] Intracerebral hemorrhage (ICH) refers to spontaneous hemorrhage in non-traumatic brain parenchyma. The vast majority are caused by the rupture of blood vessels due to arteriosclerosis in high blood pressure. About 1 / 3 of hypertensive patients will have cerebral hemorrhage, and about 95% of cerebral hemorrhage patients have high blood pressure. Cerebral hemorrhage is a common acute cerebrovascular disease in middle-aged and elderly people, with high mortality and disability rates. According to statistics from the European Stroke Association, the 1-year survival rate of patients with cerebral hemorrhage is only 46%[Steiner ...
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