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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (3): 7-13.doi: 10.6040/j.issn.1671-7554.0.2022.1331

• 专家综述 • 上一篇    下一篇

骨科冲击波治疗的智能化发展现状及趋势分析

刘亚军1,2,郎昭1,2,郭安忆1,2,刘文勇3,4,*()   

  1. 1. 北京积水潭医院国家骨科医学中心，北京 100035
    2. 北京市创伤骨科研究所，北京 100035
    3. 北京航空航天大学生物与医学工程学院，北京 100083
    4. 北京市生物医学工程高精尖创新中心，北京 100083
  • 收稿日期:2022-11-21 出版日期:2023-03-10 发布日期:2023-03-24
  • 通讯作者: 刘文勇 E-mail:wyliu@buaa.edu.cn
  • 作者简介:刘亚军，北京积水潭医院副院长、脊柱外科主任医师，北京大学医学部教授，博士研究生导师；享受国务院政府特殊津贴专家，中国医学装备协会骨与软组织损伤修复分会主任委员、中国研究型医院学会冲击波医学专业委员会副主任委员、北京生物医学工程学会秘书长；英国爱丁堡皇家外科学院Fellow(FRCS)；入选国家百千万人才工程(有突出贡献中青年专家)、青年北京学者、北京市科技新星、北京市高层次创新创业人才支持计划领军人才|主要研究领域：微创与智能骨科技术、骨与软组织损伤修复、环境与骨健康。以临床需求为牵引，开展基础与医工融合交叉研究。在致病机理方面发现了大气细颗粒物与骨关节炎的正向关联和细颗粒物在关节间隙的持续累积，阐明了大气细颗粒物致骨关节损伤的机制，拓展了环境因素与骨关节炎的新研究领域。在国内较早参与了导航机器人技术在骨科的临床应用与研究，创新骨科机器人应用领域，自主研发了冲击波治疗机器人。近5年先后主持包括国家重点研发计划和国家自然科学基金重大研究计划在内的10项国家/省部级科研项目，累计发表学术论文112篇，包括第一/通信作者论文34篇。获授权欧洲发明专利1项、国家发明专利7项和实用新型专利10项，其中4项国家发明专利和5项实用新型专利已临床转化。参与制定国际指南1项、全国学会指南5项。获国家科技进步二等奖1项、北京市科技进步一等奖3项、北京市自然科学奖二等奖1项、中华医学科技奖二等奖1项

Progresses and trends of intelligent technologies in orthopedic shock wave therapy

Yajun LIU1,2,Zhao LANG1,2,Anyi GUO1,2,Wenyong LIU3,4,*()   

  1. 1. National Center for Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China
    2. Beijing Research Institute of Traumatology and Orthopedics, Beijing 100035, China
    3. School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
    4. Beijing Advanced Innovation Center for Biomedical Engineering, Beijing 100083, China
  • Received:2022-11-21 Online:2023-03-10 Published:2023-03-24
  • Contact: Wenyong LIU E-mail:wyliu@buaa.edu.cn

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摘要：

体外冲击波治疗以其安全无创的临床优势在骨科得到了广泛应用，但传统治疗手段普遍存在的主观经验决策和手动长时操作等问题限制了该方法的推广和进一步发展。智能技术已经开始进入骨科冲击波治疗领域，并发展迅速。本文总结了计算机导航、机器学习和机器人三类智能技术在骨科冲击波治疗中的研究现状及应用特点，表明：现阶段，计算机导航可以有效辅助医生完成冲击波探头的准确定位，机器学习方法能够辅助实现冲击波治疗能量参数的自动预测；机器人已经表现出了显著的潜在临床效能，尤其是能够大幅降低医师操作强度；三类技术分别从“眼”“脑”“手”的角度，为提升骨科冲击波治疗智能化水平提供全面支持。在此基础上，本文从临床治疗机制与量效关系、方案规划智能化与临床适宜性、治疗操作自动化与机器人辅助等方面，展望了未来发展趋势。

关键词: 体外冲击波治疗, 骨科, 计算机导航, 机器学习, 医用机器人

Abstract:

Extracorporeal shock wave therapy (ESWT) is widely adopted in clinical orthopedics for its safe and non-invasive treatment. However, the experience-based subjective decision-making and long-lasting manual operation of physicians in the conventional orthopedic ESWT have limited its further development. As intelligent technologies are rapidly getting into the orthopedic ESWT, this review summarizes the state-of-the-art of research and application of intelligent technologies in orthopedic ESWT from aspects of computer navigation, machine learning and robotics. Computer navigation technologies can intuitively assist physicians to accurately locate the shock wave probe on the anatomical target of patients. The machine learning methods can automatically predict energy parameters in ESWT. Robotic systems have demonstrated their potential advantages in clinical efficacy especially in the dramatical alleviation of the operation intensity of physicians. These intelligent technologies provide comprehensive support for intellectualization of orthopedic ESWT from eye, brain and hand, respectively. This review also concludes the future technical trends from aspects of the ESWT biological mechanism and dose-effect relationship, the treatment protocol planning and usability of machine learning, and the treatment automation and robotic assistance.

Key words: Extracorporeal shock wave therapy, Orthopedics, Computer navigation, Machine learning, Medical robot

中图分类号: 

  • R454
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