【摘要】：目的:探討計算機導航技術在口腔頜面部異物取出手術中的臨床應用及對手術的指導意義,評價其臨床效果。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。術前均行CT或CBCT掃描,將CT或CBCT掃描數(shù)據以DICOM格式導入導航系統(tǒng),進行三維重建,用于術前規(guī)劃和術中導航。觀察術中導航的精確度,手術時間和患者術后反應,評價計算機導航在頜面部異物取出手術的臨床效果。結果:在計算機導航的輔助下,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。導航誤差1 mm,手術時間縮短,患者術后均未出現(xiàn)并發(fā)癥。結論:計算機導航技術不但對頜面部異物精確定位,而且減少了手術時間,減輕了患者的術后并發(fā)癥,增加了手術的精確度和安全性,對口腔頜面部異物取出手術具有重要的臨床應用價值。
[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】： 南京大學醫(yī)學院附屬口腔醫(yī)院南京市口腔醫(yī)院;
【基金】：江蘇省臨床醫(yī)學科技專項項目(編號:BL2013005) 江蘇省衛(wèi)生廳課題項目(編號:H201441)
【分類號】：R782.2

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