CN113229925B - Ablation method based on nucleus pulposus ablation pressure measurement application - Google Patents
Ablation method based on nucleus pulposus ablation pressure measurement application Download PDFInfo
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- CN113229925B CN113229925B CN202110425043.4A CN202110425043A CN113229925B CN 113229925 B CN113229925 B CN 113229925B CN 202110425043 A CN202110425043 A CN 202110425043A CN 113229925 B CN113229925 B CN 113229925B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
- A61B5/032—Spinal fluid pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00339—Spine, e.g. intervertebral disc
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
- A61B2018/00583—Coblation, i.e. ablation using a cold plasma
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A90/00—Technologies having an indirect contribution to adaptation to climate change
- Y02A90/10—Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
Abstract
The application relates to an ablation method based on nucleus pulposus ablation manometry application, which comprises the following steps: recording the initial pressure Po in the nucleus pulposus of different patients; step two: obtaining diagnostic data of the degree of lumbar disc herniation of each patient in step one; step three: grading Vx the initial pressure Po in the first step based on the diagnosis data in the second step; step four: recording the ablation pressure Pi of each patient when the ablation is completed in the first step, calculating the theoretical pressure difference Px of the corresponding patient Pi and Po, and obtaining the effective theoretical pressure difference Py according to the theoretical clinical observation data of different patients; step five: dividing the effective theoretical pressure difference Py corresponding to the initial pressure Po into the grades Vx corresponding to the third step to obtain the effective theoretical pressure difference Py corresponding to different grades Vx, and performing rapid and targeted ablation operation on the nucleus pulposus directly according to the grade Vx corresponding to the Po during ablation. The application carries out targeted and more accurate ablation operation to the patient, improves the treatment effect to the patient.
Description
Technical Field
The application relates to the technical field of nucleus pulposus ablation, in particular to an ablation method based on nucleus pulposus ablation pressure measurement application.
Background
The lumbar vertebra consists of a bony vertebral body and a relatively flexible intervertebral disc, behind which are the spinal cord and spinal nerves responsible for the sensory movements below the waist, as well as for the urination and defecation, etc. The lumbar intervertebral disc is kept fixed inside the edge of the vertebral body by the fibrous ring under normal conditions, and is contained by cerebrospinal fluid around the spinal cord, so that the intervertebral disc has no contact with the spinal cord and nerve roots. Because of the bad sitting posture and age, the human lumbar intervertebral disc can be degenerated and dehydrated, the stress on the surrounding annulus fibrosus and the rear articular process joint is correspondingly increased, the outer annulus fibrosus of the lumbar intervertebral disc is broken under the continuous extrusion of external force, the nucleus pulposus protrudes from the broken part, and nerve roots are pressed or stimulated, so that pain in the waist and buttocks (involving pain) and pain in the legs (radiating pain) are caused.
In the related art, nucleus pulposus forming operation is often adopted to treat lumbar disc herniation, the principle is that the energy generated by a plasma generator at the end part of a low-temperature plasma operation electrode is utilized to enable a highly-aggregated plasma thin layer to be formed between the plasma operation electrode and tissues, plasma in the thin layer is accelerated by an electric field, and the energy is sufficient to crush organic molecular chains in the tissues, so that the tissues are decomposed into simple molecules, atoms or low-molecular-weight gases, and vaporization, cutting, ablation and hemostasis effects are generated.
With the related technology, under the guidance of a C-shaped arm or CT, a doctor inserts a puncture needle into an intervertebral disc from a safe triangle, then acts on the intervertebral disc through a plasma operation electrode, ablates tissues around the electrode, and can totally gasify and discharge the tissues which are pressed on nerves out of the body through repeated ablation. The electrode temperature is maintained at 70 ℃ and the temperature 1mm away from the electrode is reduced to 40 ℃ in the whole ablation process, so that the possibility of damaging peripheral nerves is very small. And simultaneously, the cold coagulation effect of the plasma operation electrode can be utilized to shrink and solidify tissues around the ablation channel, so as to prevent nucleus pulposus tissues from protruding again along the ablation channel.
In summary, the nucleoplasty is actually performed for the intervertebral disc, however, when performing the nucleoplasty, what degree of ablation should be performed is generally determined by a doctor through experience after observing a CT slice of a human spine, which may cause incomplete ablation and ablation transition, and the ablation situation after the nucleoplasty cannot be known in time, which is not beneficial to performing targeted treatment on a patient, and there is a need for improvement.
Disclosure of Invention
In order to facilitate targeted treatment of a patient, the present application provides for the use of a method based on nuclear ablation manometry.
The application of the manometry method based on nucleus pulposus ablation adopts the following technical scheme:
a method for measuring the pressure of the ablation of nucleus pulposus and its application are disclosed
Step one: recording the initial pressure Po in the nucleus pulposus of different patients;
step two: obtaining diagnostic data of the degree of lumbar disc herniation of each patient in step one;
step three: grading Vx (1, 2, 3,) the initial pressure Po in step one based on the diagnostic data in step two;
step four: recording the ablation pressure Pi of each patient when the ablation is completed in the first step, calculating the theoretical pressure difference Px of the corresponding patient Pi and Po, and obtaining the effective theoretical pressure difference Py according to the theoretical clinical observation data of different patients;
step five: dividing the effective theoretical pressure difference Py corresponding to the initial pressure Po into the grades Vx corresponding to the third step to obtain the effective theoretical pressure difference Py corresponding to different grades Vx.
By adopting the technical scheme, puncture operation is carried out on different patients, so that the optical fiber pressure sensor delivers the inside of the nucleus pulposus of the patient, detects the initial pressure in the nucleus pulposus, sets the initial pressure as Po, acquires diagnostic data of the lumbar disc herniation degree of each patient, and carries out grading corresponding to the Po; and then, detecting the pressure Pi of the nucleus pulposus of each patient after ablation, calculating the theoretical pressure difference Px of the corresponding patient Pi and Po, obtaining the effective theoretical pressure difference Py according to theoretical clinical observation data of the patient in the later period, and finally dividing the effective theoretical pressure difference Py of the corresponding initial pressure Po into the grades Vx corresponding to the third step to obtain the effective theoretical pressure differences Py corresponding to the different grades Vx, namely, in the process of performing the nucleus pulposus shaping operation, dividing the effective theoretical pressure differences Py into the corresponding grades Vx according to the initial pressure Po of the patient directly and obtaining the corresponding effective theoretical pressure difference Py according to the corresponding grades Vx, and directly performing targeted ablation and decompression operation on the patient, namely, performing targeted treatment on the patient, thereby being beneficial to enhancing the treatment effect on the patient.
Preferably, in the second step, the protrusion degree of the lumbar disc of the patient is reflected by CT, and the protrusion distance of the lumbar disc of the different patients is measured as the diagnosis data.
By adopting the technical scheme, the acquisition mode of the diagnostic data is to measure the protrusion distance of the lumbar intervertebral discs of different patients under CT, thereby being beneficial to truly reflecting the degree grade of the protrusion of the lumbar intervertebral discs of the patients.
Preferably, in the fourth step, the ablation condition of the nucleus pulposus is reflected in real time by observing CT, and whether the ablation is completed is judged.
By adopting the technical scheme, the mode for judging whether ablation is completed is actually an empirical judgment in the current treatment method, has certain uncertainty, and is used as a judgment basis for the completion of ablation, so that the method is persuasive.
Preferably, in the fourth step, the theoretical clinical observation data includes a repeated period of time of the patient's condition, a degree of pain relief of the patient, and a recovery of the body function of the patient after the operation.
By adopting the technical scheme, in the fourth step, clinical observation comprises periodically revisiting the repeated time period of the patient, the pain relieving degree of the patient and the recovery condition of the body function of the patient after operation, so that the reasonable and effective theoretical pressure difference Py can be obtained.
Preferably, in the fifth step, a database of the dose-to-effect relationship is established according to the grade Vx and the effective theoretical pressure difference Py.
By adopting the technical scheme, the quantitative effect relation database is established according to the grade Vx and the effective theoretical pressure difference Py, the visual quantitative effect change curve and the corresponding quantitative effect relation equation are obtained, targeted hierarchical matching is carried out, and the reliability and the experimental performance of data utilization are improved.
Preferably, in the fifth step, the dose-to-effect relationship database is implanted into the plasma surgical system.
By adopting the technical scheme, the dose-response relation database is implanted into the plasma surgery system through the programming language, so that a user only needs to input one Po value when performing the nucleus pulposus molding operation each time, the plasma surgery system vertically outputs the grade Vx of a patient and the effective theoretical pressure difference Py correspondingly, targeted ablation and decompression operation is performed on the nucleus pulposus, the treatment effect is enhanced, and the irradiation time of the patient under CT is reduced.
Preferably, in the fourth step, whether the plasma tool bit ablates is determined according to the theoretical pressure difference Px.
By adopting the technical scheme, in practical application, whether the plasma tool bit is ablated can be judged in real time according to the magnitude of the theoretical pressure difference Px.
In order to improve the treatment efficiency of nucleus pulposus ablation and decompression, the application also provides a nucleus pulposus ablation method.
The ablation method based on nucleus pulposus ablation pressure measurement application adopts the following technical scheme:
an ablation method based on nucleus pulposus ablation manometry application, comprising
Step one: delivering a fiber optic pressure sensor into the nucleus pulposus using a puncture needle, detecting an initial pressure Po within the nucleus pulposus, and mapping it into a corresponding grade Vx;
step two: the plasma tool bit is delivered into the nucleus pulposus by the puncture needle, the plasma tool bit corresponds to a specific effective theoretical pressure difference Py according to a volume effect relation database in the plasma operation system, and then the plasma tool bit is used for carrying out ablation decompression operation within the range of the effective theoretical pressure difference Py.
Through adopting above-mentioned technical scheme, utilize pjncture needle to deliver optic fibre pressure sensor to the nucleus pulposus earlier in, detect initial pressure Po to in corresponding grade Vx with it, then, according to the volume effect relation database obtain corresponding specific effective theoretical pressure difference Py, and through the operation of plasma operation system, make the plasma tool bit carry out the targeted and ablation decompression operation of matching Py to the nucleus pulposus, carry out the targeted treatment to the patient promptly, and through the effective theoretical pressure difference Py who matches, improve the treatment to the patient greatly.
In summary, the present application includes at least one of the following beneficial technical effects:
1. according to initial pressure Po in the nucleus pulposus of different patients and corresponding diagnostic data, grading Vx corresponding to the patients, calculating theoretical pressure difference Px of the corresponding patients Pi and Po by recording Pi of a large number of patients after ablation is completed, obtaining effective theoretical pressure difference Py by obtaining theoretical observation data through a large number of clinical observations, obtaining effective theoretical pressure difference Py corresponding to different grades Vx, and performing targeted and more accurate ablation operation on the patients in the later stage;
2. by means of the change of the theoretical pressure difference Px, the ablation condition in the nucleus pulposus can be known in real time;
3. by establishing a dose-effect relation database according to the grade Vx and the effective theoretical pressure difference Py, theoretical data can be practically used, so that later clinical research is facilitated, and the curative effect of the nucleus pulposus shaping operation is enhanced.
Detailed Description
The present application is described in further detail below.
The embodiment of the application discloses an application of a manometry method based on nucleus pulposus ablation.
Applications based on nuclear ablation manometry include:
step one: the method comprises the steps that an optical fiber pressure sensor is delivered into the nucleus pulposus of a patient through a puncture needle, and the initial pressure Po in the nucleus pulposus of different patients is recorded in a mode of detecting the pressure in the nucleus pulposus of the patient;
step two: the method comprises the steps of firstly, obtaining diagnostic data of the protrusion degree of the lumbar disc of each patient, wherein the obtained diagnostic data is obtained by reflecting the protrusion degree of the lumbar disc of the patient through a CT (computed tomography) sheet shot in the early stage of CT, measuring the protrusion distance of the lumbar disc of different patients, wherein the protrusion distance is the distance from the farthest position of the fiber ring to the original surface of the fiber ring, namely, the fiber ring is used as diagnostic data;
step three: grading Vx (1, 2, 3,) the initial pressure Po in step one based on the diagnostic data in step two;
step four: recording the ablation pressure Pi of each patient when the ablation is completed in the first step, wherein the judgment mode of the completion of the ablation is based on the nucleus pulposus ablation condition which is reflected in real time by observing CT in the prior art and is obtained by judgment of experience of doctors;
calculating a theoretical pressure difference Px corresponding to the patients Pi and Po, and judging whether the plasma tool bit is ablated or not and the ablation condition by a doctor according to the theoretical pressure difference Px during actual ablation; and then clinical observation is carried out on different patients in a form of periodically revisiting the patients to obtain theoretical clinical observation data, so as to obtain an effective theoretical pressure difference Py, wherein the clinical observation data comprise repeated time periods of patient illness, the pain reduction degree of the patients and the recovery condition of body functions of the patients after operation;
step five: dividing the effective theoretical pressure difference Py corresponding to the initial pressure Po into the grades Vx corresponding to the third step to obtain the effective theoretical pressure differences Py corresponding to different grades Vx, establishing a quantitative effect relation database according to the grades Vx and the effective theoretical pressure differences Py, and implanting the quantitative effect relation database into a plasma surgery system in a programming language mode.
The embodiment of the application also discloses an ablation method based on the application of nucleus pulposus ablation pressure measurement.
The nucleus pulposus ablation method comprises the following steps:
step one: delivering a fiber optic pressure sensor into the nucleus pulposus using a puncture needle, detecting an initial pressure Po within the nucleus pulposus, and mapping it into a corresponding grade Vx;
step two: the plasma tool bit is delivered into the nucleus pulposus by the puncture needle, the plasma tool bit corresponds to a specific effective theoretical pressure difference Py according to a volume effect relation database in the plasma operation system, and then the plasma tool bit is used for carrying out ablation decompression operation within the range of the effective theoretical pressure difference Py.
The implementation principle of the application is as follows:
when the application based on the nucleus pulposus ablation manometry is successfully established, a doctor firstly utilizes a puncture needle to deliver an optical fiber pressure sensor into the nucleus pulposus of a patient during nucleus pulposus molding operation, detects the initial pressure Po in the nucleus pulposus, finds out the corresponding grade Vx according to the initial pressure Po, inputs the initial pressure Po and the corresponding grade Vx into a plasma operation system, and enables the initial pressure Po to correspond to a specific effective theoretical pressure difference Py according to a volume effect relation database in the plasma operation system, and converts the volume effect to correspond to the volume to be ablated;
then, removing the optical fiber pressure sensor, delivering a plasma cutter head into the nucleus pulposus of the patient, and performing electrode ablation on the nucleus pulposus according to the effective theoretical pressure difference Py; the patient is subjected to targeted and more accurate ablation operation, so that the treatment effect on the patient is greatly improved, the irradiation time of the patient under CT is reduced, and the damage to the patient caused by irradiation of CT is further reduced.
The foregoing are all preferred embodiments of the present application, and are not intended to limit the scope of the present application in any way, therefore: all equivalent changes in structure, shape and principle of this application should be covered in the protection scope of this application.
Claims (6)
1. An application of a manometry method based on nucleus pulposus ablation, which is characterized in that: comprising
Step one: recording the initial pressure Po in the nucleus pulposus of different patients;
step two: obtaining diagnostic data of the degree of lumbar disc herniation of each patient in step one;
step three: grading Vx the initial pressure Po in the first step based on the diagnosis data in the second step;
step four: recording the ablation pressure Pi of each patient when the ablation is completed in the first step, calculating the theoretical pressure difference Px of the corresponding patient Pi and Po, and obtaining the effective theoretical pressure difference Py according to the theoretical clinical observation data of different patients;
step five: dividing the effective theoretical pressure difference Py corresponding to the initial pressure Po into the grades Vx corresponding to the third step to obtain the effective theoretical pressure difference Py corresponding to different grades Vx.
2. The use of a method of manometry based on ablation of the nucleus pulposus according to claim 1, wherein: the diagnosis data in the second step is data reflecting the protrusion degree of the lumbar disc of the patient through CT and measuring the protrusion distance of the lumbar disc of different patients.
3. The use of a method of manometry based on ablation of the nucleus pulposus according to claim 1, wherein: in the fourth step, the theoretical clinical observation data comprise repeated time periods of patient illness, the pain reduction degree of the patient and the recovery condition of the body function of the patient after operation.
4. The use of a method of manometry based on ablation of the nucleus pulposus according to claim 1, wherein: in the fifth step, a quantity-effect relation database is established according to the grade Vx and the effective theoretical pressure difference Py.
5. The use of a method of manometry based on ablation of the nucleus pulposus according to claim 4, wherein: in the fifth step, the dose-effect relation database is implanted into a plasma operation system.
6. The use of a method of manometry based on ablation of the nucleus pulposus according to claim 1, wherein: in the fourth step, whether the plasma tool bit ablates or not is judged according to the theoretical pressure difference Px.
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