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目的评估磁场导航智能定位(IP)系统引导穿刺的准确性。方法将煮熟的鹌鹑蛋包埋于魔芋凝胶制备实验模型,以蛋黄中心作为穿刺目标,按穿刺目标深度分为近距离组(穿刺目标深度<50 mm)、中距离组(穿刺目标深度50～100 mm)和远距离组(穿刺目标深度>100 mm),每组分别采用IP系统引导和常规超声引导各穿刺5个模型。测量、计算并比较穿刺误差(穿刺针道与穿刺目标的距离),记录并比较穿刺次数和穿刺用时。结果对于近、中、远距离目标,IP系统引导穿刺误差分别为(1.88±1.18)、(1.56±0.56)、(3.99±1.10)cm,常规超声引导穿刺误差分别为(4.52±2.23)、(4.49±1.73)、(3.93±2.19)cm。对于近、中距离目标,IP系统引导穿刺误差均小于常规超声引导,且差异均有统计学意义(t=-2.345,P=0.047;t=-3.608,P=0.007);而对于远距离目标,IP系统引导与常规超声引导的穿刺误差间差异无统计学意义(t=0.058,P=0.955)。IP系统引导下,对于远距离目标的穿刺误差均大于近、中距离目标,且差异均有统计学意义(t=1.073,P=0.011;t=-0.188,P=0.042);而近距离目标与中距离目标的穿刺误差间差异无统计学意义(t=-1.927,P=0.501)。IP系统引导下均一次完成穿刺;对于近、中、远距离目标,常规超声引导穿刺次数中位数分别为2、1、2次。对于近、远距离目标,IP系统引导穿刺次数均少于常规超声引导,且差异均有统计学意义(U=-2.372,P=0.018;U=-2.390,P=0.032);而对于中距离目标,IP系统引导与常规超声引导穿刺次数间差异无统计学意义(U=-1.000,P=0.690)。对于近、中、远距离目标,IP系统引导穿刺用时分别为(21.20±2.39)、(27.00±4.00)、(31.80±3.83)s,常规超声引导穿刺用时分别为(45.20±9.68)、(26.80±4.21)、(54.60±13.48)s。对于近、远距离目标,IP系统引导穿刺用时均明显少于常规超声引导,且差异均有统计学意义(t=-5.383,P=0.001;t=-3.637,P=0.007);而对于中距离目标,IP系统引导与常规超声引导穿刺用时差异无统计学意义(t=0.077,P=0.916)。结论 IP系统引导下能直观显示穿刺路径,相对于常规超声引导,可减少穿刺误差、穿刺次数及穿刺用时。
Objective To assess the accuracy of Guided Magnetic Positioning (IP) system guidance puncture. Methods The cooked quail eggs were embedded in konjac gel to prepare the experimental model. The center of the egg yolk was used as the puncture target. According to the depth of the puncture target, the quail eggs were divided into close range (the depth of the puncture target <50 mm), the middle distance group ~ 100 mm) and long-distance group (depth of puncture target> 100 mm). Five groups of each model were guided by IP system and conventional ultrasound. Measurement, calculation and comparison of puncture error (puncture needle and puncture target distance), record and compare the number of punctures and puncture time. Results For the near, middle and long-range targets, the guiding errors of IP system were (1.88 ± 1.18), (1.56 ± 0.56) and (3.99 ± 1.10) cm, respectively, and the errors of conventional ultrasound guided puncture were (4.52 ± 2.23) and 4.49 ± 1.73), (3.93 ± 2.19) cm. For the near and middle distance targets, the IP guided errors were less than those of conventional ultrasound guidance, and the differences were statistically significant (t = -2.345, P = 0.047; t = -3.608, P = 0.007) There was no significant difference between IP system guidance and routine ultrasound guidance puncture error (t = 0.058, P = 0.955). IP system, the error of puncturing for long-range target was greater than that of near-middle and long-range target, and the difference was statistically significant (t = 1.073, P = 0.011; t = -0.188, P = 0.042) There was no significant difference in puncture error between the target and middle distance target (t = -1.927, P = 0.501). IP system under the guidance of a single puncture; for the near, middle and long-range goals, the median number of routine ultrasound guided puncture were 2,1,2 times. For the near and far targets, the number of guiding IP punctures was less than that of conventional ultrasound guidance (P = 0.018; U = -2.372, P = 0.018); while for middle distance There was no significant difference between the goal, IP system guidance and routine ultrasound guided puncture (U = -1.000, P = 0.690). For the near, middle and long-range targets, the time spent on guiding the puncturing was (21.20 ± 2.39) and (31.80 ± 3.83) s for the IP system and (45.20 ± 9.68) and (26.80 ± 4.21), (54.60 ± 13.48) s. For short-term and long-range targets, the time spent on guiding the puncture of IP system was significantly less than that of conventional ultrasound guidance (t = -5.383, P = 0.001; t = -3.637, P = 0.007) There was no significant difference in the distance between target and IP system guidance and routine ultrasound guided puncture (t = 0.077, P = 0.916). Conclusions The IP system can directly display the puncture path under the guidance of the guideline, which can reduce the puncture error, the number of punctures and the puncture time compared with the conventional ultrasound guidance.