CN106175893A - A kind of arching trajectory implants the method and device of intracranial electrode - Google Patents
A kind of arching trajectory implants the method and device of intracranial electrode Download PDFInfo
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- CN106175893A CN106175893A CN201610625864.1A CN201610625864A CN106175893A CN 106175893 A CN106175893 A CN 106175893A CN 201610625864 A CN201610625864 A CN 201610625864A CN 106175893 A CN106175893 A CN 106175893A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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Abstract
The present invention proposes a kind of arching trajectory and implants the method and device of intracranial electrode, for realizing the single electrode puncture track through multiple intracranial targets at intracranial, the Arcuate puncture sleeve pipe that described implantation intracranial electrode method uses radian fixing introduces electrode to intracranial, described Arcuate puncture sleeve pipe guides through the arc guiding sleeve that radian is fixing and realizes Needle localization, described arc guiding sleeve is fixed on the tool of location, described location tool is provided with the adjustable anchor point of positioning framework and position, described anchor point is provided with fixture, when arc guiding sleeve is fixed through anchor point and fixture, arc guiding sleeve completes location；When described arc guiding sleeve positions, the circumference of the arc place circle of arc guiding sleeve is through multiple targets of intracranial；The invention provides method for implantation and the orienting device stimulating multiple target spots with single electrode.
Description
Technical field
The present invention relates to medical instruments field, a kind of arching trajectory implants the method and device of intracranial electrode.
Background technology
Deep brain stimulation refers to be guided by iconography (CT, MRI) location and stereotaxis device, is inserted by microelectrode
The specific target spot of intracranial, the functional neurosurgery surgical operation for the treatment of central nervous system disorders.Current stereotactic apparatus both domestic and external,
Being arcuate position finder, principle is centre of sphere method.Use step is: first, the reference positioned as image using tridimensional orienting headstock
Labelling, is placed in a three dimensions by brain, measures the cartesian coordinate (X, Y, Z) of target.Secondly, vertical by regulation
X, Y, Z arm on body position finder, makes the center of circle of arc bow on position finder overlap with target.Finally, arcuate position finder is pacified
It is contained on framework, any point from arc bow, inserts electrode with the direction perpendicular with curved cut line, all can be by predetermined ball
The heart, completes the embedding art of electrode of target.This alignment system has accurate, easy advantage, at stereotactic neurosurgery
Operation plays an important role.
But electrode can only be placed to simple target target spot by current stereotactic apparatus, gradually cannot meet clinical needs.
Based on current substantial amounts of clinical research, the lesions located in deep brain effect of double target spots tends to the effect of stimulation being better than single target spot.Ratio
As: the Parkinsonian center line symptom poor effect inside subthalamic nuclei and pallidum, it is main patient for center line symptom, makes
More preferable effect can be reached with pontine nucleus and subthalamic nuclei associating electricity irritation.For this type of situation, the current location is used to be
System, can only be, in operation process, multiple core groups are respectively implanted multiple electrode.But consider the expensive of intracranial electrode, many
Secondary intracranial electrode produces certain damage to cerebral tissue during inserting, and unitary electrode how can be allowed through multiple intracranial mesh
Target point, has important clinical value.There is presently no method and the stereotaxis dress stimulating multiple target spots for unitary electrode
Put.
Summary of the invention
The present invention proposes a kind of arching trajectory and implants the method and device of intracranial electrode, it is provided that stimulate multiple with single electrode
The piercing method of target spot and orienting device.
The present invention is by the following technical solutions.
A kind of arching trajectory implants the method and device of intracranial electrode, for realizing single electrode through multiple intracranial at intracranial
The puncture track of target, it is characterised in that: described implantation intracranial electrode method uses the Arcuate puncture sleeve pipe that radian is fixing
Introducing electrode to intracranial, described Arcuate puncture sleeve pipe guides through the arc guiding sleeve that radian is fixing and realizes Needle localization, described
Arc guiding sleeve is fixed on the tool of location, and described location tool is provided with the adjustable anchor point of positioning framework and position, described
Anchor point is provided with fixture, and when arc guiding sleeve is fixed through anchor point and fixture, arc guiding sleeve completes
Location；When described arc guiding sleeve positions, the circumference of the arc place circle of arc guiding sleeve is through multiple mesh of intracranial
Target point.
Described location tool includes that positioning framework, perpendicular plate slide block, perpendicular plate, switching horizontal plate, locating dowel, deflection angle are surveyed
Amount dish and some location bar, described perpendicular plate is arranged in pairs, and perpendicular plate is slided with the sliding positioning framework dual-side that is placed in of perpendicular plate slide block
Sliding before and after at groove, perpendicular plate is inserted in sliding up and down in the vertical chute of perpendicular plate slide block；Described switching horizontal plate is with level
The chute of plate slide block is placed at perpendicular plate and lifts, and is provided with the locating dowel slide block being placed on switching horizontal plate bottom described locating dowel,
Described locating dowel slide block is provided with the alignment pin for fixed deflection angular surveying dish, and described deflection angle measurement dish is placed through fixed
On the post of position and be positioned pin and fix；Some positioning through hole that in described locating dowel, evenly distributed setting is positioned on same vertical,
Described some location bar is placed through in positioning through hole, and the end of location bar is provided with anchor point, and anchor point is provided with for fixing arc
The locating ring of shape guiding sleeve, described perpendicular plate slide block, horizontal plate slide block, locating dowel slide block are equipped with sliding locking device.
The arc place circle of described arc guiding sleeve is positioned in vertical direction.
When relying on location tool to set up cartesian coordinate system, the X-axis of cartesian coordinate system is set up on switching horizontal plate, switching
There is X-axis rule on horizontal plate, be provided with X-axis telltale mark at locating dowel slide block for X-axis reading；Location bar is provided with deflection footmark
Note is for positioning the deflection angle reading of bar；Y-axis is set up in positioning framework side edge, and positioning framework side has Y-axis rule, hangs down
Y-axis telltale mark is had for Y-axis reading inside straight plate slide block；Z axis is set up on perpendicular plate, with the zeromark of perpendicular plate central authorities
For Z axis initial point, arranging rule to upper and lower two ends, the most downward rule is Z axis rule, is provided with outside perpendicular plate slide block
Z axis telltale mark is used for Z axis reading.
The anchor point quantity of described location tool is two, and the coordinate setting of described location tool anchor point is divided into following step
Suddenly.
A1, in cranium week along being horizontally mounted positioning framework, carry out cranium CT, MRI check with determine two be positioned at intracranial with
The target of one vertical plane, relies on location tool to set up cartesian coordinate system, measures respectively and be positioned at the first of the deep position of intracranial
The coordinate of the second target spot of target spot and the shallow position of intracranial, if in cartesian coordinate system the coordinate of the first target spot be (X1, Y1, Z1) and
The coordinate of two target spots is (X2, Y2, Z2)；The vertical plane at the first target spot and the second target spot place is guide plane, with the first target
Coordinate in the X/Y plane of cartesian coordinate system of point, the second target spot calculate guide plane and cartesian coordinate system YZ plane it
Between deflection angle angle value S；Set up the guiding coordinate system of two dimension, described guiding coordinate system with the first target spot for initial point at guide plane
Y-axis parallel with the Z axis of cartesian coordinate system, calculate the second target spot with this and guiding the coordinate (X3, Y3) in coordinate system.
A2, selection radius suitable arc guiding sleeve and Arcuate puncture sleeve pipe, if arc guiding sleeve and Arcuate puncture
The radius of sleeve pipe is r, then guiding in coordinate system, be electrode with r as radius and through the circle of the first target spot and the second target spot
Puncture track, calculate electrode and puncture the center of circle (X4, Y4) of track, show that electrode punctures the expression equation of track.
A3, choose for fixing two location bars of arc guiding sleeve in locating dowel, location bar is being guided coordinate system
Two interior Y-axis coordinate Ya and Yb substitute into electrodes puncture equations of locus and solve the elements of a fix, draw in guiding coordinate system
It is positioned at electrode and punctures X-axis coordinate Xa, Xb corresponding with Ya, Yb on track.
A4, two locating point positions adjusted on the bar of location, make two anchor points arrive the elements of a fix, and the elements of a fix are drawing
Leading the coordinate in coordinate system is (Xa, Ya) and (Xb, Yb).
When being calculated the deflection angle angle value between guide plane and the YZ plane of cartesian coordinate system by excel spreadsheet formulas
During S, excel spreadsheet formulas is S=IF (X2 > X1,1 ,-1) * ACOS (ABS (Y1-Y2)/SQRT ((X1-X2) ^2+ (X1-X2) ^
2))/PI()*180；
When being calculated second target spot coordinate in guiding coordinate system by excel spreadsheet formulas, excel spreadsheet formulas is X3=
IF(Y2<Y1,1,-1)*SQRT((X1-X2)^2+(Y1-Y2)^2) Y3=Z1-Z2；
When being calculated electrode by excel spreadsheet formulas and puncturing the center of circle of track coordinate in guiding coordinate system, excel form
Formula is X4=Y3^2/ (2*X3)+O3/2-Y3*Y4/X3 Y4=((X3^2*Y3+Y3^3)/X3^2+SQRT (((X3^2*Y3+Y3^
3)/X3^2)^2-4*((Y3/X3)^2+1)*S3))/(2*((Y3/X3)^2+1))；
It is (X-X4) ^2+(Y-Y4 that electrode punctures the expression equation of track) ^2=r^2；
The excel spreadsheet formulas being substituted into Ya, Yb calculating Xa, Xb by excel spreadsheet formulas within representing equation is Xa=X4+
SQRT(r^2-(Y4-Ya)^2) Xb=X4+SQRT(r^2-(Y4-Yb)^2)。
Described arc guiding sleeve is divided into multiple specification by size, and the radius of the radian of the arc guiding sleeve of each specification is not
With, the bore of arc guiding sleeve of each specification, pipe external diameter are the most identical with pipe range, the pipe range of the arc guiding sleeve of each specification
It is respectively less than Arcuate puncture sleeve pipe；The pipe external diameter of the arc guiding sleeve of each specification mates with the locating ring internal diameter of anchor point.
Described Arcuate puncture sleeve pipe is divided into multiple specification by size, and the radius of the radian of the Arcuate puncture sleeve pipe of each specification is not
With, the bore of Arcuate puncture sleeve pipe of each specification, pipe external diameter are the most identical with pipe range, outside the pipe of the Arcuate puncture sleeve pipe of each specification
Footpath matches with the bore of arc locating sleeve；The built-in puncture casing core of Arcuate puncture sleeve pipe, described puncture casing core
One end be provided with handguard and handle, the other end of puncture casing core shows and is placed at the end mouth of pipe of Arcuate puncture sleeve pipe, and arc is worn
The end mouth of pipe of thorn sleeve pipe is the first stimulation position corresponding with the first target spot, and the sidewall of Arcuate puncture sleeve pipe is provided with a sidewall mouth,
This sidewall mouth is the second stimulation position corresponding with the second target spot；Be marked with in the outer wall surface of Arcuate puncture sleeve pipe rule in order to
Length is inserted in observation.
It is divided into following steps when intracranial implant electrode.
B1, first locating dowel is inserted deflection angle measurement dish, two location bars are loaded in locating dowel, rotate location bar and make
Deflection angle labelling on the bar of location arrives deflection angle angle value S on deflection angle measurement dish；Adjusting locating dowel slide block makes X-axis position
Labelling arrives at the X1 value of X-axis rule, adjusts perpendicular plate slide block and makes Y-axis telltale mark arrive at the Y1 value of Y-axis rule, adjusts
Whole horizontal plate slide block makes Z axis telltale mark arrive at the Z1 value of Z axis rule, locks perpendicular plate slide block, horizontal plate slide block and determines
Position post slide block, completes the location of locating dowel and makes location bar be positioned at guide plane, adjusting two location bars in locating dowel
Position, makes two location bar end anchor points arrive the elements of a fix；
B2, choose when arc extends can the arc guiding sleeve of through two anchor points, locating ring is fixed arc guide sleeves
Pipe, arc guiding sleeve uses as guide rail need not enter intracranial；
B3, set on Arcuate puncture sleeve pipe first stimulate position, second stimulate the spacing of position as L1, if intracranial the first target spot, the second target
The spacing of point is L2, and choosing radian mates with arc guiding sleeve, and the Arcuate puncture sleeve pipe of L1=L2, at arc guiding sleeve
Being inserted into Arcuate puncture sleeve pipe, Arcuate puncture sleeve pipe inserts intracranial under the guiding of arc guiding sleeve, after the second target spot
Continuing deeper into, until the end of Arcuate puncture sleeve pipe arrives the first target spot, now first stimulates position to be positioned at the first target spot, and second
Position is stimulated to be positioned at the second target spot；
B4, taking-up puncture casing core, make Arcuate puncture cannula cavity vacant；
B5, in vacant Arcuate puncture cannula cavity implant electrode, electrode enters under the constraint of Arcuate puncture sleeve pipe tube chamber
Intracranial, until electrode end arrives the exit of Arcuate puncture sleeve pipe, now electrode body is in Arcuate puncture sleeve pipe tube chamber
Under constraint and protection, electrode body through the distal opening of Arcuate puncture sleeve pipe and sidewall mouth respectively with the first target spot and the second target spot
Contact.
The present invention, according to Arcuate puncture track place circle road feature outside intracranial and cranium simultaneously, sets up arc fixed outside cranium
Site, uses the puncture casing of arc to limit puncture radian simultaneously, thus sets up anchor point, the location arc that matches of radian
Shape Needle localization method, accurate positioning, it is only necessary to measure two target spots of the embedding intracranial electrode of needs on iconography image
Coordinate, and select suitable puncture casing according to the judgement of operator, it is possible to calculated by two target spot institutes by formula
The adjusted value of the stereotaxis device needed for " electrode track " needed, and foundation " electrode track ", auxiliary at stereotaxis device
The double target spot intracranial electrode of single electrode is realized embedding under helping.Compared with the prior art, the present invention has filled up and cannot realize with single electrode
The blank that Mutiple Targets stimulates, and process is easy, accurate positioning.
The present invention is when setting up cartesian coordinate system, and Z axis is set up on perpendicular plate, with the zeromark of perpendicular plate central authorities is
Z axis initial point, arranges rule to upper and lower two ends, and the most downward rule is Z axis rule, is provided with Z outside perpendicular plate slide block
Axle telltale mark is used for Z axis reading；So when operation, in Z-direction coordinate setting to first and second target spot be in fact
Z axis initial point place plane is to carry out on the rightabout of the plane of symmetry, such as increase coordinate Z-axis direction depth value positioning action be to
Being raised perpendicular plate, the outer mirror image of cranium that this design provides intracranial target sets up structure, i.e. intracranial target is put down with Z axis initial point place
The point of symmetry that face is symmetrical can be positioned at outside cranium, and outside cranium, the point of symmetry of the first target spot are positioned at low level and the point of symmetry of the second target spot
Be positioned at a high position, due to puncture locus circle with Z axis initial point place plane as symmetry, the first target spot, the point of symmetry of the first target spot, second
Target spot, the point of symmetry of the second target spot are respectively positioned on puncture track, directly carry out calculating with point of symmetry when therefore calculating, and simplify
Amount of calculation, promotes work efficiency.
In the present invention, perpendicular plate is inserted in sliding up and down in the vertical chute of perpendicular plate slide block；Described switching horizontal plate with
The chute of horizontal plate slide block is placed at perpendicular plate and lifts；This design is provided with two set slip modes on vertical, makes it and this
Invent described pair of coordinate location method to coordinate, it is easy to understand and operate.
The arc guiding sleeve combination that positioning and fixing structure that the present invention uses anchor point variable is constant with radian is real
Now positioning, thus simplify amount of calculation, its Modeling Calculation mode is also closer to clinic, it is simple to implement.
Accompanying drawing explanation
The present invention is described in more detail with detailed description of the invention below in conjunction with the accompanying drawings:
Accompanying drawing 1 is the overall structure schematic diagram of location of the present invention tool；
Accompanying drawing 2 is that locating dowel of the present invention, location bar, deflection angle measurement dish three assemble schematic diagram；
Accompanying drawing 3 is locating dowel of the present invention, location bar, deflection angle measurement dish three's assembling section；
Accompanying drawing 4 is the schematic diagram of arc guiding sleeve of the present invention；
Accompanying drawing 5 is the schematic diagram of Arcuate puncture sleeve pipe of the present invention；
Accompanying drawing 6 is the schematic diagram of puncture casing core of the present invention；
Accompanying drawing 7 is the assembling schematic diagram of arc guiding sleeve of the present invention, Arcuate puncture sleeve pipe and puncture casing core；
Accompanying drawing 8 is the schematic diagram of locating dowel of the present invention；
In figure: 1-positioning framework；2-perpendicular plate slide block；3-perpendicular plate；4-transfers horizontal plate；5-locating dowel；6-positions bar；18-
Deflection angle measurement dish；20-positioning through hole；25-arc guiding sleeve；26-Arcuate puncture sleeve pipe；27-puncture casing core；28-
Handguard；29-handle；101-anchor point；102-locating dowel slide block；103-horizontal plate slide block；104-alignment pin.
Detailed description of the invention
As shown in Fig. 1,2,3,4,5,6,7, a kind of arching trajectory implants the method and device of intracranial electrode, at intracranial
Realizing the single electrode puncture track through multiple intracranial targets, described implantation intracranial electrode method uses the arc that radian is fixing
Shape puncture casing introduces electrode to intracranial, and described Arcuate puncture sleeve pipe guides through the arc guiding sleeve that radian is fixing and realizes puncturing
Location, described arc guiding sleeve is fixed on the tool of location, and described location tool is provided with positioning framework 1 and position is adjustable fixed
Site 101, described anchor point 101 is provided with fixture, when arc guiding sleeve 25 is fixed through anchor point 101 and fixture
Time, arc guiding sleeve 25 completes location；When described arc guiding sleeve 25 positions, the arc place of arc guiding sleeve 25
The circumference of circle is through multiple targets of intracranial.
Described location tool includes positioning framework 1, perpendicular plate slide block 2, perpendicular plate 3, switching horizontal plate 4, locating dowel 5, deflection
Angular surveying dish 18 and some location bar 6, described perpendicular plate 3 is arranged in pairs, and perpendicular plate 3 is placed in location so that perpendicular plate slide block 2 is sliding
Sliding before and after at framework 1 dual-side chute, perpendicular plate 3 is inserted in sliding up and down in the vertical chute of perpendicular plate slide block 2；Described turn
Water receiving flat board 4 is placed at perpendicular plate 3 with the chute of horizontal plate slide block 103 and lifts, and is provided with and is placed in switching water bottom described locating dowel 5
Locating dowel slide block 102 on flat board 4, described locating dowel slide block 102 is provided with the location for fixed deflection angular surveying dish 18
Pin 104, described deflection angle measurement dish 18 is placed through in locating dowel 5 and is positioned pin 104 and fixes；In described locating dowel 5 uniformly
Spread configuration is positioned at the some positioning through hole 20 on same vertical, and described some location bar 6 is placed through in positioning through hole 20, fixed
The end of position bar 6 is provided with anchor point 101, and anchor point 101 is provided with the locating ring for fixing arc guiding sleeve, described vertically
It is equipped with sliding locking device on plate slide block 2, horizontal plate slide block 103, locating dowel slide block 102.
The arc place circle of described arc guiding sleeve 25 is positioned in vertical direction.
When relying on location tool to set up cartesian coordinate system, the X-axis of cartesian coordinate system is set up on switching horizontal plate 4, is turned
There is X-axis rule on water receiving flat board 4, be provided with X-axis telltale mark at locating dowel slide block 102 for X-axis reading；Location bar 6 is provided with
Deflection angle labelling is for positioning the deflection angle reading of bar 6；Y-axis is set up in positioning framework 1 side edge, and positioning framework 1 side has Y
Axle rule, has Y-axis telltale mark for Y-axis reading inside perpendicular plate slide block 2；Z axis is set up on perpendicular plate 3, with perpendicular plate 3
The zeromark of central authorities is Z axis initial point, arranges rule to upper and lower two ends, and the most downward rule is Z axis rule, vertically
Z axis telltale mark it is provided with for Z axis reading outside plate slide block.
The anchor point quantity of described location tool is two, and the coordinate setting of described location tool anchor point is divided into following step
Suddenly.
A1, in cranium week along being horizontally mounted positioning framework, carry out cranium CT, MRI check with determine two be positioned at intracranial with
The target of one vertical plane, relies on location tool to set up cartesian coordinate system, measures respectively and be positioned at the first of the deep position of intracranial
The coordinate of the second target spot of target spot and the shallow position of intracranial, if in cartesian coordinate system the coordinate of the first target spot be (X1, Y1, Z1) and
The coordinate of two target spots is (X2, Y2, Z2)；The vertical plane at the first target spot and the second target spot place is guide plane, with the first target
Coordinate in the X/Y plane of cartesian coordinate system of point, the second target spot calculate guide plane and cartesian coordinate system YZ plane it
Between deflection angle angle value S；Set up the guiding coordinate system of two dimension, described guiding coordinate system with the first target spot for initial point at guide plane
Y-axis parallel with the Z axis of cartesian coordinate system, calculate the second target spot with this and guiding the coordinate (X3, Y3) in coordinate system.
A2, selection radius suitable arc guiding sleeve and Arcuate puncture sleeve pipe, if arc guiding sleeve and Arcuate puncture
The radius of sleeve pipe is r, then guiding in coordinate system, be electrode with r as radius and through the circle of the first target spot and the second target spot
Puncture track, calculate electrode and puncture the center of circle (X4, Y4) of track, show that electrode punctures the expression equation of track.
A3, choose for fixing two location bars of arc guiding sleeve in locating dowel, location bar is being guided coordinate system
Two interior Y-axis coordinate Ya and Yb substitute into electrodes puncture equations of locus and solve the elements of a fix, draw in guiding coordinate system
It is positioned at electrode and punctures X-axis coordinate Xa, Xb corresponding with Ya, Yb on track.
A4, two locating point positions adjusted on the bar of location, make two anchor points arrive the elements of a fix, and the elements of a fix are drawing
Leading the coordinate in coordinate system is (Xa, Ya) and (Xb, Yb).
When being calculated the deflection angle angle value between guide plane and the YZ plane of cartesian coordinate system by excel spreadsheet formulas
During S, excel spreadsheet formulas is S=IF (X2 > X1,1 ,-1) * ACOS (ABS (Y1-Y2)/SQRT ((X1-X2) ^2+ (X1-X2) ^
2))/PI()*180；
When being calculated second target spot coordinate in guiding coordinate system by excel spreadsheet formulas, excel spreadsheet formulas is X3=
IF(Y2<Y1,1,-1)*SQRT((X1-X2)^2+(Y1-Y2)^2) Y3=Z1-Z2；
When being calculated electrode by excel spreadsheet formulas and puncturing the center of circle of track coordinate in guiding coordinate system, excel form
Formula is X4=Y3^2/ (2*X3)+O3/2-Y3*Y4/X3 Y4=((X3^2*Y3+Y3^3)/X3^2+SQRT (((X3^2*Y3+Y3^
3)/X3^2)^2-4*((Y3/X3)^2+1)*S3))/(2*((Y3/X3)^2+1))；
It is (X-X4) ^2+(Y-Y4 that electrode punctures the expression equation of track) ^2=r^2；
The excel spreadsheet formulas being substituted into Ya, Yb calculating Xa, Xb by excel spreadsheet formulas within representing equation is Xa=X4+
SQRT(r^2-(Y4-Ya)^2) Xb=X4+SQRT(r^2-(Y4-Yb)^2)。
Described arc guiding sleeve 25 is divided into multiple specification by size, the radius of the radian of the arc guiding sleeve 25 of each specification
Difference, the bore of arc guiding sleeve of each specification, pipe external diameter are the most identical with pipe range, the pipe of the arc guiding sleeve of each specification
Long respectively less than Arcuate puncture sleeve pipe；The pipe external diameter of the arc guiding sleeve of each specification mates with the locating ring internal diameter of anchor point.
Described Arcuate puncture sleeve pipe 26 is divided into multiple specification by size, the radius of the radian of the Arcuate puncture sleeve pipe 26 of each specification
Difference, the bore of Arcuate puncture sleeve pipe 26 of each specification, pipe external diameter are the most identical with pipe range, the Arcuate puncture sleeve pipe 26 of each specification
The bore of pipe external diameter and arc locating sleeve 25 match；The built-in puncture casing core 27 of Arcuate puncture sleeve pipe 26, institute
The one end stating puncture casing core 27 is provided with handguard 28 and handle 29, and the other end of puncture casing core 27 is aobvious is placed in Arcuate puncture sleeve pipe
At the end mouth of pipe of 26, the end mouth of pipe of Arcuate puncture sleeve pipe 26 is the first stimulation position corresponding with the first target spot, Arcuate puncture
The sidewall of sleeve pipe is provided with a sidewall mouth, and this sidewall mouth is the second stimulation position corresponding with the second target spot；Outside Arcuate puncture sleeve pipe
It is marked with rule on wall surface and inserts length in order to observe.
It is divided into following steps when intracranial implant electrode.
B1, first locating dowel is inserted deflection angle measurement dish, two location bars are loaded in locating dowel, rotate location bar and make
Deflection angle labelling on the bar of location arrives deflection angle angle value S on deflection angle measurement dish；Adjusting locating dowel slide block makes X-axis position
Labelling arrives at the X1 value of X-axis rule, adjusts perpendicular plate slide block and makes Y-axis telltale mark arrive at the Y1 value of Y-axis rule, adjusts
Whole horizontal plate slide block makes Z axis telltale mark arrive at the Z1 value of Z axis rule, locks perpendicular plate slide block, horizontal plate slide block and determines
Position post slide block, completes the location of locating dowel and makes location bar be positioned at guide plane, adjusting two location bars in locating dowel
Position, makes two location bar end anchor points arrive the elements of a fix；
B2, choose when arc extends can the arc guiding sleeve of through two anchor points, locating ring is fixed arc guide sleeves
Pipe, arc guiding sleeve uses as guide rail need not enter intracranial；
B3, set on Arcuate puncture sleeve pipe first stimulate position, second stimulate the spacing of position as L1, if intracranial the first target spot, the second target
The spacing of point is L2, and choosing radian mates with arc guiding sleeve, and the Arcuate puncture sleeve pipe of L1=L2, at arc guiding sleeve
Being inserted into Arcuate puncture sleeve pipe, Arcuate puncture sleeve pipe inserts intracranial under the guiding of arc guiding sleeve, after the second target spot
Continuing deeper into, until the end of Arcuate puncture sleeve pipe arrives the first target spot, now first stimulates position to be positioned at the first target spot, and second
Position is stimulated to be positioned at the second target spot；
B4, taking-up puncture casing core, make Arcuate puncture cannula cavity vacant；
B5, in vacant Arcuate puncture cannula cavity implant electrode, electrode enters under the constraint of Arcuate puncture sleeve pipe tube chamber
Intracranial, until electrode end arrives the exit of Arcuate puncture sleeve pipe, now electrode body is in Arcuate puncture sleeve pipe tube chamber
Under constraint and protection, electrode body through the distal opening of Arcuate puncture sleeve pipe and sidewall mouth respectively with the first target spot and the second target spot
Contact.
Claims (9)
1. arching trajectory implants a method and device for intracranial electrode, for realizing single electrode through multiple intracranial mesh at intracranial
The puncture track of target point, it is characterised in that: described implantation intracranial electrode method use the fixing Arcuate puncture sleeve pipe of radian to
Intracranial introduces electrode, and described Arcuate puncture sleeve pipe guides through the arc guiding sleeve that radian is fixing and realizes Needle localization, described arc
Shape guiding sleeve is fixed on the tool of location, and described location tool is provided with the adjustable anchor point of positioning framework and position, described fixed
Site is provided with fixture, and when arc guiding sleeve is fixed through anchor point and fixture, arc guiding sleeve completes fixed
Position；When described arc guiding sleeve positions, the circumference of the arc place circle of arc guiding sleeve is through multiple targets of intracranial
Target spot.
A kind of arching trajectory the most according to claim 1 implants the method and device of intracranial electrode, it is characterised in that: described
Location tool includes positioning framework, perpendicular plate slide block, perpendicular plate, switching horizontal plate, locating dowel, deflection angle measurement dish and some fixed
Position bar, described perpendicular plate is arranged in pairs, and perpendicular plate slides sliding before and after being placed at positioning framework dual-side chute with perpendicular plate slide block,
Perpendicular plate is inserted in sliding up and down in the vertical chute of perpendicular plate slide block；Described switching horizontal plate is put with the chute of horizontal plate slide block
Lift at perpendicular plate, bottom described locating dowel, be provided with the locating dowel slide block being placed on switching horizontal plate, described locating dowel slide block
Being provided with the alignment pin for fixed deflection angular surveying dish, described deflection angle measurement dish is placed through in locating dowel and is positioned
Pin is fixing；Some positioning through hole that in described locating dowel, evenly distributed setting is positioned on same vertical, described some location bar
Being placed through in positioning through hole, the end of location bar is provided with anchor point, and anchor point is provided with for fixing determining of arc guiding sleeve
Position ring, described perpendicular plate slide block, horizontal plate slide block, locating dowel slide block are equipped with sliding locking device.
A kind of arching trajectory the most according to claim 2 implants the method and device of intracranial electrode, it is characterised in that: described
The arc place circle of arc guiding sleeve is positioned in vertical direction.
A kind of arching trajectory the most according to claim 3 implants the method and device of intracranial electrode, it is characterised in that: rely on
When location tool sets up cartesian coordinate system, the X-axis of cartesian coordinate system is set up on switching horizontal plate, and switching horizontal plate has X
Axle rule, is provided with X-axis telltale mark for X-axis reading at locating dowel slide block；Location bar is provided with deflection angle labelling for positioning
The deflection angle reading of bar；Y-axis is set up in positioning framework side edge, and positioning framework side has Y-axis rule, in perpendicular plate slide block
There is Y-axis telltale mark side for Y-axis reading；Z axis set up on perpendicular plate, with perpendicular plate central authorities zeromark for Z axis initial point,
Arrange rule to upper and lower two ends, the most downward rule is Z axis rule, is provided with Z axis location mark outside perpendicular plate slide block
Note is for Z axis reading.
A kind of arching trajectory the most according to claim 4 implants the method and device of intracranial electrode, it is characterised in that: described
The anchor point quantity of location tool is two, and the coordinate setting of described location tool anchor point is divided into following steps；
A1, in cranium week along being horizontally mounted positioning framework, carry out cranium CT, MRI checks to determine that two are positioned at that intracranial is same to hang down
The target of straight plane, relies on location tool to set up cartesian coordinate system, measures the first target spot being positioned at the deep position of intracranial respectively
The coordinate of the second target spot of position shallow with intracranial, if the coordinate of the first target spot is (X1, Y1, Z1) and the second target in cartesian coordinate system
The coordinate of point is (X2, Y2, Z2)；The vertical plane at the first target spot and the second target spot place is guide plane, with the first target spot,
Two target spots coordinate in the X/Y plane of cartesian coordinate system calculates between guide plane and the YZ plane of cartesian coordinate system
Deflection angle angle value S；Set up the guiding coordinate system of two dimension, the Y of described guiding coordinate system with the first target spot for initial point at guide plane
Axle is parallel with the Z axis of cartesian coordinate system, calculates the second target spot with this and is guiding the coordinate (X3, Y3) in coordinate system；
A2, selection radius suitable arc guiding sleeve and Arcuate puncture sleeve pipe, if arc guiding sleeve and Arcuate puncture sleeve pipe
Radius be r, then guiding in coordinate system, with r as radius and be electrode through the circle of the first target spot and the second target spot and puncture
Track, calculates electrode and punctures the center of circle (X4, Y4) of track, show that electrode punctures the expression equation of track；
A3, choose for fixing two location bars of arc guiding sleeve in locating dowel, location bar in guiding coordinate system
Two Y-axis coordinate Ya and Yb substitute into electrode puncture equation of locus and solve the elements of a fix, draw and are positioned in guiding coordinate system
Electrode punctures X-axis coordinate Xa, Xb corresponding with Ya, Yb on track；
A4, two locating point positions adjusted on the bar of location, make two anchor points arrive the elements of a fix, and the elements of a fix are guiding seat
The coordinate that mark is fastened is (Xa, Ya) and (Xb, Yb).
A kind of arching trajectory the most according to claim 5 implants the method and device of intracranial electrode, it is characterised in that: when logical
When crossing deflection angle angle value S that excel spreadsheet formulas calculates between guide plane and the YZ plane of cartesian coordinate system, excel table
Lattice formula is S=IF (X2 > X1,1 ,-1) * ACOS (ABS (Y1-Y2)/SQRT ((X1-X2) ^2+ (X1-X2) ^2))/PI () * 180；
When being calculated second target spot coordinate in guiding coordinate system by excel spreadsheet formulas, excel spreadsheet formulas is X3=
IF(Y2<Y1,1,-1)*SQRT((X1-X2)^2+(Y1-Y2)^2) Y3=Z1-Z2；
When being calculated electrode by excel spreadsheet formulas and puncturing the center of circle of track coordinate in guiding coordinate system, excel form
Formula is X4=Y3^2/ (2*X3)+O3/2-Y3*Y4/X3 Y4=((X3^2*Y3+Y3^3)/X3^2+SQRT (((X3^2*Y3+Y3^
3)/X3^2)^2-4*((Y3/X3)^2+1)*S3))/(2*((Y3/X3)^2+1))；
It is (X-X4) ^2+(Y-Y4 that electrode punctures the expression equation of track) ^2=r^2；
The excel spreadsheet formulas being substituted into Ya, Yb calculating Xa, Xb by excel spreadsheet formulas within representing equation is Xa=X4+
SQRT(r^2-(Y4-Ya)^2) Xb=X4+SQRT(r^2-(Y4-Yb)^2)。
A kind of arching trajectory the most according to claim 5 implants the method and device of intracranial electrode, it is characterised in that: described
Arc guiding sleeve is divided into multiple specification by size, and the radius of the radian of the arc guiding sleeve of each specification is different, the arc of each specification
The bore of shape guiding sleeve, pipe external diameter are the most identical with pipe range, and the pipe range respectively less than arc of the arc guiding sleeve of each specification is worn
Thorn sleeve pipe；The pipe external diameter of the arc guiding sleeve of each specification mates with the locating ring internal diameter of anchor point.
A kind of arching trajectory the most according to claim 7 implants the method and device of intracranial electrode, it is characterised in that: described
Arcuate puncture sleeve pipe is divided into multiple specification by size, and the radius of the radian of the Arcuate puncture sleeve pipe of each specification is different, the arc of each specification
The bore of shape puncture casing, pipe external diameter are the most identical with pipe range, and the pipe external diameter of the Arcuate puncture sleeve pipe of each specification positions with arc
The bore of sleeve pipe matches；The built-in puncture casing core of Arcuate puncture sleeve pipe, one end of described puncture casing core is provided with to be protected
Hands and handle, the other end of puncture casing core shows and is placed at the end mouth of pipe of Arcuate puncture sleeve pipe, the end of Arcuate puncture sleeve pipe
The mouth of pipe is corresponding with the first target spot the first stimulation position, and the sidewall of Arcuate puncture sleeve pipe is provided with a sidewall mouth, this sidewall mouth be with
The second stimulation position that second target spot is corresponding；It is marked with rule in the outer wall surface of Arcuate puncture sleeve pipe and inserts length in order to observe
Degree.
A kind of arching trajectory the most according to claim 8 implants the method and device of intracranial electrode, it is characterised in that: to cranium
It is divided into following steps when being implanted into electrode；
B1, first locating dowel is inserted deflection angle measurement dish, two location bars are loaded in locating dowel, rotate location bar and make location
Deflection angle labelling on bar arrives deflection angle angle value S on deflection angle measurement dish；Adjust locating dowel slide block and make X-axis telltale mark
Arrive at the X1 value of X-axis rule, adjust perpendicular plate slide block and make Y-axis telltale mark arrive at the Y1 value of Y-axis rule, adjust water
Flat board slide block makes Z axis telltale mark arrive at the Z1 value of Z axis rule, locking perpendicular plate slide block, horizontal plate slide block and locating dowel
Slide block, completes the location of locating dowel and makes location bar be positioned at guide plane, adjusting two location bars position in locating dowel,
Two location bar end anchor points are made to arrive the elements of a fix；
B2, choose when arc extends can the arc guiding sleeve of through two anchor points, locating ring is fixed arc guide sleeves
Pipe, arc guiding sleeve uses as guide rail need not enter intracranial；
B3, set on Arcuate puncture sleeve pipe first stimulate position, second stimulate the spacing of position as L1, if intracranial the first target spot, the second target
The spacing of point is L2, and choosing radian mates with arc guiding sleeve, and the Arcuate puncture sleeve pipe of L1=L2, at arc guiding sleeve
Being inserted into Arcuate puncture sleeve pipe, Arcuate puncture sleeve pipe inserts intracranial under the guiding of arc guiding sleeve, after the second target spot
Continuing deeper into, until the end of Arcuate puncture sleeve pipe arrives the first target spot, now first stimulates position to be positioned at the first target spot, and second
Position is stimulated to be positioned at the second target spot；
B4, taking-up puncture casing core, make Arcuate puncture cannula cavity vacant；
B5, in vacant Arcuate puncture cannula cavity implant electrode, electrode enters under the constraint of Arcuate puncture sleeve pipe tube chamber
Intracranial, until electrode end arrives the exit of Arcuate puncture sleeve pipe, now electrode body is in Arcuate puncture sleeve pipe tube chamber
Under constraint and protection, electrode body through the distal opening of Arcuate puncture sleeve pipe and sidewall mouth respectively with the first target spot and the second target spot
Contact.
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| CN106805971A (en) * | 2017-03-13 | 2017-06-09 | 北京理工大学 | Tactile cerebration stimulating apparatus and tactile cerebration stimulate terminal system |
| CN106859603A (en) * | 2017-03-13 | 2017-06-20 | 北京理工大学 | Tactile cerebration stimulating apparatus and adjusting part |
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| CN107252524A (en) * | 2017-04-25 | 2017-10-17 | 北京品驰医疗设备有限公司 | A kind of electrode fixes anchor |
| CN108294810A (en) * | 2017-01-11 | 2018-07-20 | 疏龙飞 | A kind of Quantitative Study of Lateral Ventricle puncture of frontal angle guiding locator |
| CN110215290A (en) * | 2019-07-09 | 2019-09-10 | 方竹亭 | A kind of tridimensional orienting headstock |
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