中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9797-9801.doi: 10.3969/j.issn.2095-4344.2012.52.021

• 骨与关节损伤基础实验 basic experiments of bone and joint injury • 上一篇    下一篇

三维虚拟穿刺仿真在颈部神经阻滞中的应用

曹加明1，傅 栋2   

  1. 1解放军98医院麻醉科，浙江省湖州市 313000
    2武警8691部队医院，浙江省湖州市 313003
  • 收稿日期:2012-04-26 修回日期:2012-06-08 出版日期:2012-12-23 发布日期:2013-03-12
  • 通讯作者: 傅栋，博士，主治医师，武警8691部队医院，浙江省湖州市 313003
  • 作者简介:曹加明★，男，1969年生，浙江省永康市人，汉族，2009年浙江大学医学院毕业，硕士，副主任医师，主要从事麻醉学相关研究。 caoyl1023@qq.com

Application of three-dimensional virtual punctuation simulation in cervical nerve block

Cao Jia-ming1, Fu Dong2   

  1. 1 Department of Anesthesiology, 98th Hospital of Chinese PLA, Huzhou 313000, Zhejiang Province, China;
    2 8691 Hospital of Armed Police Forces, Huzhou 313003, Zhejiang Province, China
  • Received:2012-04-26 Revised:2012-06-08 Online:2012-12-23 Published:2013-03-12
  • Contact: Fu Dong, M.D., Attending physician, 8691 Hospital of Armed Police Forces, Huzhou 313003, Zhejiang Province, China
  • About author:Cao Jia-ming★, Master, Associate chief physician, Department of Anesthesiology, 98th Hospital of Chinese PLA, Huzhou 313000, Zhejiang Province, China caoyl1023@qq.com

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摘要：

背景：颈部神经阻滞麻醉易引起严重麻醉意外与并发症，目前在建立颈部神经三维可视化模型并对颈部神经节阻滞进行虚拟仿真方面还处在临床探索阶段。
目的：寻求三维虚拟穿刺仿真在颈部神经阻滞中的应用方法。
方法：取健康志愿者颈部连续CT动脉造影/MRI脊髓造影断面图像，Mimics软件对骨骼、肌肉、动静脉、甲状腺、喉软骨、脊髓等组织进行半自动分割和重建，医学计算机辅助设计模块对神经等细小解剖结构进行重建，三维化显示颈部神经及周围相关解剖结构，并进行颈部神经穿刺虚拟仿真，包括模拟颈浅丛阻滞，颈深丛阻滞和星状神经节阻滞。
结果与结论：成功模拟颈浅丛阻滞, 颈深丛阻滞和星状神经节阻滞，显示虚拟穿刺针和骨性结构、动静脉、肌肉、脊髓、颈丛深浅支和星状神经节等解剖结构的三维毗邻关系，并测量穿刺进针的安全角度,深度和最佳穿刺路径。说明三维虚拟穿刺仿真技术可以为颈部神经阻滞术提供直观的形态学参考。

关键词: 三维, 虚拟仿真, 穿刺术, 神经阻滞, 颈丛, 星状神经节, 数字化医学

Abstract:

BACKGROUND: Neck nerve block anesthesia could easily cause a serious anesthetic accidents and complications. Till now, we are in the clinical exploration stage in establishment of three-dimensional visual model of the cervical nerve and virtual simulation of cervical nerve block.
OBJECTIVE: To explore the application of three-dimensional virtual punctuation simulation in cervical nerve block.
METHODS: Continuous CT angiography and MRI myelography sectional images were selected from the cervical part of one healthy volunteer, half-auto cut and reconstruction were taken to skeleton, muscles, artery, veins, thyroid gland, laryngeal cartilages and spinal cord etc. with the Mimics software. Medical computer-aided design module was used to reconstruct the nerve and other small anatomical structures. Three-dimensional model of cervical nerves and its surrounding relational local anatomic structure were successfully displayed and cervical nerves punctuation were virtual emulated, including simulation of superficial cervical plexus block, deep cervical plexus and stellate block.
RESULTS AND CONCLUSION: Superficial cervical plexus block, deep cervical plexus and stellate block were successfully simulated, three-dimensions adjoin relation of the virtual pin with skeleton, carotid arteries, jugular veins, muscles, spinal cord, cervical plexus and stellate ganglion were successfully displayed, and pin’s safe angle, depth or optimization path were measured. A three-dimensional virtual punctuation simulation can provide visualized morphologic data for cervical nerve block.

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