Role of CT-guided three-dimensional puncture positioning device in the management of sympathetic modulation

Objective To investigate the values of CT-guided three-dimensional puncture positioning device in the management of sympathetic modulation. Methods From January,2015 to January,2016,60 patients proposed for thoracic or lumber sympathetic modulation in our hospital were enrolled into study.According to the principle of completely random digital table,one side was punctured under the guidance of CT-guided three-dimensional puncture positioning device(guided technique),while the other side was punctured under the CT-guided conventional puncture technique(conventional technique).Thoracic intervertebral puncture was performed between T₃ and T₄ till the needle tip reached the spot around T₄ and above capitis;Lumber intervertebral puncture was performed between L₂ and L₃ till the needle tip reached the lateral side of L₃ and anterior side of the psoas muscle.The temperature of hands or feet、the patient's finger or toe tip perfusion index were recorded before the operation(T0),10 minutes and 24 h(T1,T2)after operation.Also,the time consumed during puncture,CT scan adjusting time,the deviation of the needle from the targets and the incidence of puncture complications were recorded. Results In two Groups,perfusion index and the temperature of hands or feet raised (7.73±1.23) times and (4.97±0.94)℃ in average,respectively.All of the patients were cured within 3 months.When compared with the conventional technique,guided technique got a significantly shorter time consumed during puncture[(14.85±3.27)min vs. (35.35±3.10)min,P<0.001],the number of attempts and the deviation of the needle from the target were significantly reduced[3.25±0.91 vs. 8.65±1.79,P<0.001],[(3.70±1.22)° vs. (12.20±2.58)°,P<0.001].The procedure was successfully performed on both side in all patients without serious complications such as hemothorax and pneumothorax. Conclusion CT-guided three-dimensional puncture positioning device in the management of sympathetic modulation can shorten the puncture time,improve the success rate of puncture,it is worthy of clinical promotion.