【摘要】：目的:探討計(jì)算機(jī)導(dǎo)航技術(shù)在口腔頜面部異物取出手術(shù)中的臨床應(yīng)用及對手術(shù)的指導(dǎo)意義,評價(jià)其臨床效果。方法:從2014年1月~2016年12月我院共收治的5例口腔頜面部異物患者。術(shù)前均行CT或CBCT掃描,將CT或CBCT掃描數(shù)據(jù)以DICOM格式導(dǎo)入導(dǎo)航系統(tǒng),進(jìn)行三維重建,用于術(shù)前規(guī)劃和術(shù)中導(dǎo)航。觀察術(shù)中導(dǎo)航的精確度,手術(shù)時間和患者術(shù)后反應(yīng),評價(jià)計(jì)算機(jī)導(dǎo)航在頜面部異物取出手術(shù)的臨床效果。結(jié)果:在計(jì)算機(jī)導(dǎo)航的輔助下,5例患者共發(fā)現(xiàn)28個異物:5個玻璃碎屑,16個小彈片,7個金屬碎片。其中1例金屬碎片因參考架松動未能精確定位,重新固定參考架后,所有異物均精確定位并通過微創(chuàng)的方法成功取出。導(dǎo)航誤差1 mm,手術(shù)時間縮短,患者術(shù)后均未出現(xiàn)并發(fā)癥。結(jié)論:計(jì)算機(jī)導(dǎo)航技術(shù)不但對頜面部異物精確定位,而且減少了手術(shù)時間,減輕了患者的術(shù)后并發(fā)癥,增加了手術(shù)的精確度和安全性,對口腔頜面部異物取出手術(shù)具有重要的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to explore the clinical application of computer navigation technique in the extraction of foreign body in oral and maxillofacial region and its guiding significance and evaluate its clinical effect. Methods: from January 2014 to December 2016, 5 cases of oral and maxillofacial foreign bodies were treated in our hospital. CT or CBCT scanning was performed before operation, and CT or CBCT scanning data were imported into the navigation system in the form of DICOM for 3D reconstruction, which was used for preoperative planning and intraoperative navigation. The accuracy of intraoperative navigation, operative time and postoperative response were observed, and the clinical effect of computer navigation in maxillofacial foreign body extraction was evaluated. Results: a total of 28 foreign bodies including 5 glass fragments, 16 small shrapnel and 7 metal fragments were found in 5 patients assisted by computer navigation. One of the metal fragments failed to locate precisely because of loosening of the reference frame. After the reference frame was refixed, all foreign bodies were accurately located and successfully removed by the minimally invasive method. The navigation error of 1 mm, was shortened and no postoperative complications were found. Conclusion: the computer navigation technique not only can accurately locate the foreign body in maxillofacial region, but also reduces the operation time, reduces the postoperative complications, and increases the accuracy and safety of the operation. It has important clinical application value for the extraction of foreign body in oral and maxillofacial region.
【作者單位】： 南京大學(xué)醫(yī)學(xué)院附屬口腔醫(yī)院南京市口腔醫(yī)院;
【基金】：江蘇省臨床醫(yī)學(xué)科技專項(xiàng)項(xiàng)目(編號:BL2013005) 江蘇省衛(wèi)生廳課題項(xiàng)目(編號:H201441)
【分類號】：R782.2

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