| Objective A new type of CT-guided puncture positioning device has been developed in order to improve the accuracy and safety of CT-guided percutaneous puncture positioning,and to explore its clinical application value.Materials and methods This paper is divided into simulation experiment and clinical study,simulation experiment:The volume of 25cm×20cm×15cm pork was used to simulate normal human muscle tissue,and clay was used to make several cuboid simulated lesions with the length of 5mm,10 mm and 15 mm respectively.The planned depths from the body surface were 30 mm,50mm and 80 mm,respectively.The simulated lesions were scattered in the pork simulating normal muscle tissue according to their size and depth,and the planned injection angles were 0°,25°and 50°at the same level.Comparison was made between CT guided manual puncture and puncture with positioning device to needle insertion angle error and puncture accuracy of simulate lesions.Clinical study : Sixteen patients who underwent CT-guided percutaneous needle biopsy in our hospital from November 2017 to July 2019 were retrospectively selected as the control group,and the manual puncture method was adopted.A total of 15 patients who underwent CT-guided puncture needle biopsy from August 2019 to November 2020 were selected as the observation group,and puncture location device was used to assist puncture.There were 31 patients in the two groups,including 19 males and 12 females,aged 47 to 87 years old,with an average age of 68 years old.There was no statistical difference between the two groups in clinical data such as age,lesion size,and needle insertion depth(P > 0.05).The times of needle insertion,operation time,CT scan times and the incidence of complications were compared between the two groups.Results There were 578 times of CT guided manual puncture and the use of positioning device to puncture simulated lesions.The puncture accuracy rate of the experimental group was as high as 94.8%,while that of the control group was only51.7%.The puncture accuracy of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P < 0.05).The injection angle error of the experimental group and the control group was 1°(0°,1°)and 3°(1°,7°),respectively,and the injection angle error of the experimental group was lower than that of the control group(P < 0.05).The skew of puncture in the experimental group was significantly lower than that in the control group,and the skew of puncture in the two groups was 2.4% and 23.4%respectively,with statistical significance(P < 0.05).In the clinical experiment,puncture was successful in both groups.The average puncture times of the experimental group and the control group were(1.60±0.83)times and(3.06±1.02)times respectively,and the average puncture times of the experimental group was significantly lower than those of the control group(P < 0.05).The average CT scan times of the experimental group and the control group were(5.00±1.0)times and(6.19±1.94)times respectively,and the operative time was(16.9±5.2)min and(21.7±5.8)min,respectively.Compared with the control group,the operative time and average CT scan times of the experimental group were shortened,and the difference was statistically significant(P < 0.05).Conclusion The CT-guided puncture positioning device we developed has the advantages of reasonable design and strong practicability.The use of this positioning device to assist puncture can significantly improve the puncture accuracy and safety under CT-guided puncture. |
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