CN116172704A

CN116172704A - Craniocerebral positioning puncture method

Info

Publication number: CN116172704A
Application number: CN202310250743.3A
Authority: CN
Inventors: 徐勇; 徐博文; 李午阳; 赵东明; 徐涛
Original assignee: Shenzhen Huiji Innovative Medical Technology Co ltd
Current assignee: Shenzhen Huiji Innovative Medical Technology Co ltd
Priority date: 2023-03-16
Filing date: 2023-03-16
Publication date: 2023-05-30

Abstract

The invention belongs to the technical field of craniocerebral puncture positioning, and in particular relates to a craniocerebral positioning puncture method, which comprises the following steps: the head of the patient is provided with a fixed marker for CT scanning and CT images are led into a positioning system; performing craniocerebral three-dimensional reconstruction to calibrate a focus central point 0 and finishing registration; inputting a radius value R of a tail end running spherical track of the mechanical arm in a positioning system; marking the puncture point A by using a probe with a marker and finishing registration; generating the puncture direction and puncture depth of the AO connecting line in the craniocerebral model; the tail end of the mechanical arm is matched with the puncture guide rail to be overlapped and locked with the AO straight line, and then craniocerebral puncture is carried out.

Description

Craniocerebral positioning puncture method

Technical Field

The invention belongs to the technical field of craniocerebral puncture positioning, and particularly relates to a craniocerebral puncture positioning method.

Background

And positioning the hematoma position of the patient with cerebral hemorrhage according to the CT image of the skull by utilizing CT panning influence and combining the anatomical knowledge of a doctor, and determining the puncture position and the puncture point by taking the center of the hematoma as a target point. The puncture site is usually selected to be the position closest to the scalp without large blood vessels or important functional areas, after conventional disinfection, the puncture site is locally infiltrated for anesthesia, scalp incision is made at the puncture site, a vascular clamp or periosteum stripper is used for separating periosteum, a skull drilling is carried out by a skull tapering device or a skull drilling device, a drainage tube with a built-in tube core is penetrated after the dura mater is punctured, the hematoma is penetrated through brain tissues according to the pre-operation planning direction and depth, part of the hematoma is extracted to reduce the cranium pressure, CT is required to be reviewed after operation, puncture path bleeding is eliminated, and the position of the drainage tube is determined.

However, the above common clinical puncture operation mode in the prior art requires that an operator makes accurate judgment on the intracranial hematoma position after three-dimensional reconstruction of a CT image by means of hard professional knowledge, then a reasonable puncture path is designed in the puncture process, a functional area and important blood vessels are avoided, the requirements on the operator are high, meanwhile, aiming at complex individual differences, manual puncture cannot be performed accurately once in place, repeated puncture is likely to cause iatrogenic damage to normal brain tissues, and irreversible serious complications are brought.

Disclosure of Invention

In order to solve the above-mentioned shortcomings in the prior art, the present invention provides a craniocerebral positioning puncture method, which is used for solving the above-mentioned existing problems.

In order to solve the technical problems, the invention adopts the following technical scheme:

a craniocerebral positioning puncture method, comprising the following steps:

s1, installing a fixed marker on the head of a patient and performing CT scanning;

s2, guiding an image formed by CT scanning into a positioning system;

s3, reconstructing a craniocerebral model in a three-dimensional manner in a positioning system, calibrating the focus position, identifying and positioning focus center position coordinates through the space positions of the markers, and recording the focus center point O in the positioning system;

s4, taking a focus center point O registered by the positioning system as a mechanical arm movement center point, and inputting a radius value R of a movement track of a spherical surface of the tail end of the mechanical arm in the system;

s5, according to the planning of the operation puncture path, lightly touching the scalp by using a probe with a reflective ball marker, and inputting the puncture point A into a positioning system to finish the registration of the puncture point A;

s6, the positioning system automatically generates a puncture path AO connecting line of the focus according to the space position of the point A, and calculates an AO distance, namely puncture depth;

s7, the positioning system sends out a command to enable the tail end of the mechanical arm to move around the point O, the axis direction of the puncture track is overlapped with the space straight line AO, and then the direction of the puncture track of the terminal is locked through an automatic locking mechanism of the mechanical arm;

s8, performing craniocerebral puncture.

Further, in the step S1, the marker is provided with a reflective ball with a special reflective coating.

Further, in the step S2, the positioning system is a near infrared optical positioning system.

Compared with the prior art, the invention has the following beneficial effects:

1. the invention can accurately position the focus position, reconstruct craniocerebral anatomy structure by combining near infrared visual perception markers with craniocerebral CT images, position focus center in three-dimensional images and register in a system;

2. the puncture point can be accurately identified, the puncture point is input into the system by touching the marker point, the registration of the puncture point is completed, the doctor's operation thought is imported into the system, the positioning puncture principle is simple and direct, and the doctor does not need complex operation;

3. according to the invention, the mechanical arm replaces manual puncture, after a puncture scheme is determined, the computer drives the mechanical arm to match with a registered puncture path of the system to automatically position, and locks the puncture direction through the enclasping mechanism after positioning, so that stable direction retention is realized instead of a human hand, and peripheral brain tissue damage is reduced;

4. according to the automatic puncture needle, the puncture needle can be driven to enter the needle depth by the terminal executing mechanism of the mechanical arm after the puncture direction is locked, the depth is obtained in advance according to the distance from the puncture point registered in advance to the center of a focus, and automatic puncture is realized to replace manual puncture.

Drawings

FIG. 1 is a flow chart of the principle of craniocerebral positioning puncture according to the embodiment 1 of the craniocerebral positioning puncture method of the present invention;

fig. 2 is a flow chart of the principle of craniocerebral positioning puncture according to embodiment 2 of the invention.

Description of the embodiments

In order that those skilled in the art will better understand the present invention, the following technical scheme of the present invention will be further described with reference to the accompanying drawings and examples.

Wherein the drawings are for illustrative purposes only and are shown in schematic, non-physical, and not intended to be limiting of the present patent; for the purpose of better illustrating embodiments of the invention, certain elements of the drawings may be omitted, enlarged or reduced and do not represent the size of the actual product; it will be appreciated by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted.

Examples

Example 1

As shown in fig. 1, a craniocerebral positioning puncture principle flow chart shown in fig. 1 is that a fixed marker is arranged on the head of a patient before operation, and the core of the marker is a special reflective coating of a reflective ball belt head, which can reflect near infrared light so that a visual perception component of the system can identify the spatial position of a reflective ball. The near infrared optical positioning system is optical navigation equipment for tracking and positioning based on binocular stereoscopic vision, has high synchronism and stability, can dynamically track the position of a tool in a specific three-dimensional space in real time, and has tracking precision of 0.12mm. The marker can be attached to the head or face, or can be fixed to the head of the patient through a head frame. According to the three-dimensional space positioning basic element, the number of the reflective balls of the marker is at least 4, and 5 reflective balls are preferable in the embodiment, so that the marker can still be effectively recognized and positioned by the visual perception component under the condition that the positions of the reflective balls are verified or the individual reflective balls are blocked.

After the markers are fixed, the patient needs to carry the markers to carry out craniocerebral CT scanning, the scanning image can acquire the intracranial focus position and boundary, and the space position of the markers is also acquired by the CT scanning image. The CT image data is imported into a computer system to reconstruct a brain model in three dimensions, a doctor can mark the focus position in the computer, the focus center position coordinates are identified and positioned through the space positions of the markers, and the focus center point O is registered in the computer.

In order to achieve the precision and cost consideration of the puncture mechanical arm, the motion track of the mechanical arm defaults to do spherical motion around a set point. The focus center point O registered by the system is used as a movement center point of the mechanical arm, and a movement track radius value R is input into a computer, so that patients cannot be touched by mistake in any movement process of the mechanical arm, and the safety of the patients is ensured. So far, the end actuating mechanism of the mechanical arm of the equipment moves on a spherical surface taking the point O as the center of the sphere and the R value as the radius, and meanwhile, the puncture guide rail direction of the end actuating mechanism always points to the center point O of the sphere, namely the focus center point in the movement process of the mechanical arm.

A doctor of a puncture path of a craniocerebral lesion generally designs and plans a reasonable puncture path according to the relative position relation between the lesion position and surrounding important tissues and blood vessels so as to reduce the damage of brain tissues in operation and reduce postoperative complications. The doctor lightly touches the scalp by using a probe with a reflective ball marker according to the planning of the operation puncture path, and inputs the puncture point A into the system to finish the registration of the puncture point A. The computer automatically generates a puncture path AO connecting line of the production focus according to the space position of the point A, and calculates the AO distance to be the puncture depth. The brain tissue and the brain blood vessel in the important intracranial functional area can be identified and respectively developed through image software processing, the brain tissue and the blood vessel on the puncture path can be previewed on a system screen, whether the puncture path is reasonable or not can be determined in advance, and adjustment can be made in time.

After the puncture path is calculated according to the puncture depth, the computer sends out an instruction to enable the tail end of the mechanical arm to move around the point O, the axial direction of the puncture track is overlapped with the space straight line AO, and then the automatic locking mechanism of the mechanical arm locks the direction of the puncture track of the terminal. Because the axis direction of the puncture track always points to the point O of the sphere center, the position of the point A is matched in the space coordinate and coincides with the axis direction of the puncture track, the operation process and the calculation amount of a computer can be simplified, the complex space coordinate matching is simplified into the space matching of the puncture point A, the path matching operation can be simplified, the path positioning precision is improved, the path selection time is shortened, and the operation efficiency and the operation precision are improved.

After the puncture angle is automatically matched and locked by the mechanical arm, the puncture action is selectable in a manual mode and an automatic mode. The doctor can select to puncture along the puncture track manually according to habit after the skull lockhole is opened, and the puncture depth is the AO distance obtained by systematic operation. The special puncture needle is adopted, and the tail end of the special puncture needle is provided with a reflecting ball which can feed back the position of the needle point of the puncture needle in real time in the system, so that a dynamic picture of virtual influence in the puncture process is realized, and the visual craniocerebral puncture is realized. The automatic puncture mechanical arm end actuating mechanism is selected to drive the puncture probe to enter the needle along the axis direction of the puncture track, the needle entering depth is AO distance, and meanwhile, the real-time picture of the needle tip can be displayed by a computer screen in real time, so that accurate visual puncture is realized, doctor operation is simplified, the professional requirement on a doctor is reduced, and the popularization of the primary hospital of the operation type is facilitated.

Example two

As shown in fig. 2, after registration of the focus center point O and the puncture point a is completed by the same method as in the first embodiment, the input distance L is used to define the minimum safe distance between the manipulator and the patient's head during the matching AO linear motion, so as to ensure that the end of the manipulator will not contact the patient's head during the moving process. After the axis of the puncture track at the tail end of the mechanical arm is matched with the straight line where the AO is located in the space range, the distance from the point A is kept at the safe distance of L, the position of the puncture track is locked, and then manual puncture or automatic puncture can be selected to enter the needle.

The foregoing is merely exemplary of the present invention, and the specific structures and features well known in the art are not described in any way herein, so that those skilled in the art will be able to ascertain all prior art in the field, and will not be able to ascertain any prior art to which this invention pertains, without the general knowledge of the skilled person in the field, before the application date or the priority date, to practice the present invention, with the ability of these skilled persons to perfect and practice this invention, with the help of the teachings of this application, with some typical known structures or methods not being the obstacle to the practice of this application by those skilled in the art. It should be noted that modifications and improvements can be made by those skilled in the art without departing from the structure of the present invention, and these should also be considered as the scope of the present invention, which does not affect the effect of the implementation of the present invention and the utility of the patent.

Claims

1. A craniocerebral positioning puncture method, which is characterized by comprising the following steps:

s2, guiding an image formed by CT scanning into a positioning system;

s8, performing craniocerebral puncture.

2. A method of craniocerebral positioning puncture according to claim 1, wherein: in the step S1, the marker is provided with a reflective ball with a special reflective coating.

3. A method of craniocerebral positioning puncture according to claim 2, wherein: in the step S2, the positioning system is a near infrared optical positioning system.