神器在手，史上最烧脑迷宫也没在怕的

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                    <blockquote><p><span>让天下没有难找的医疗器械服务信息！</span></p><p><strong><span>“医疗器械助手”</span></strong><span>&nbsp;让一切触手可及！</span></p><p><p><img src="image/20201014/ac7c4c86bff3f0660e634292dc511095_1.jpg" /></p></p><p><span>点击图片</span><span><span></span><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p></span></p></blockquote><p>&nbsp;</p><section><section powered-by="gulangu"><section><section><section><section></section></section><section><section><section><section powered-by="gulangu"><section><section><p><strong>大家还记得前一阵红遍网络的<span>重庆高架桥吗？</span></strong></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/4310e65abf6d7ea1890c7de5641f29c8_5.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p>这座号称“史上最烧脑”的高架桥拥有5层8个方向20条匝道的魔幻设计，复杂程度足以让百度沉默、高德流泪，在上面走错一步，就得被迫来个重庆一日游。</p><p><br  /></p><p>无数过客在这座高架桥上发出了“我是谁？我在哪儿？”的终极问题。重庆，凭借着迷宫般的高架桥，成为了一座“来了就再也出不去”的城市。</p></section></section></section><section powered-by="gulangu"><section><section><section><section><section></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p>不过，能逼死导航系统的重庆高架桥和人体的肺比起来，只能算是小儿科。</p><p><br  /></p><p>就像下图的结构，肺部的气管向下分成左右支气管，随后每一级都会分出更多枝杈，细分级数能多达23-25级，形成像迷宫一样的支气管树。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/39023f3e7913ac2d41eaa71432ce4f4c_6.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>如此复杂的支气管结构可以让进入肺部的空气被分流到各个角落，最后在支气管末端的肺泡里和血液充分融合，提供身体必需的氧气。</p><p><br  /></p><p>但同时，错综复杂的支气管“路况”也给疾病的诊断和治疗带来了很大麻烦，最典型的例子就是穷凶极恶的众癌之王——肺癌。</p><p><br  /></p></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><p><p><img src="image/20201014/bf00eab1d301dafb7b81be005c2bc318_7.jpg" /></p></p><p><mpcpc js_editor_cpcad="" data-category_id_list="12|15|14|17|16|8|9|10|24|37|11|35|29|25|7|26|5" src="https://mp.weixin.qq.com/cgi-bin/readtemplate?t=tmpl/cpc_tmpl"></mpcpc></p></section><section powered-by="gulangu"><section><section><p>在人类对抗癌症的历史上，全球发病率最高的肺癌一直是座难以攻克的堡垒。<span>2012年，全球罹患肺癌的患者超过180万，死亡率接近20%。不论是新发病例还是死亡率都居于癌症首位。在中国，由于老龄化、吸烟和环境污染等因素，肺癌的发病率每年增加近27%。<span>1 2</span></span><span></span></p><p><br  /></p><p>如此严峻的生存现状，<span>主要归咎于肺癌难以在早期被确诊</span>。据统计，我国有75%的肺癌患者在确诊时已经处于晚期，当他们发现疾病时，就已经丧失了对抗癌症的主动权。<span>3</span></p><p><br  /></p><p>为什么肺癌难以被及早发现？支气管的复杂结构要负很大的责任——在肺癌早期，肿瘤常常发生在位置偏远的支气管末端，就像隐匿在迷宫里的凶手，很难被发现和追踪。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>当患者通过CT或X光扫描发现肺部有可疑的阴影，为了进一步确认是否属于恶性肿瘤，他们通常面临下面几种选择：</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section></section></section><section><section powered-by="gulangu"><section><section><p><strong><span>支气管镜</span></strong><span>：</span>这是一种将内镜置入呼吸道直接观察、取样的手段。<span>但因为尺寸太大、又没有清晰的路径参考，无法进入复杂狭窄的外周支气管</span>。对于生长在外周支气管、尺寸小于2厘米的病变组织，<span>传统支气管镜的诊断成功率只有14%</span>。<span>4</span></p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/30c3e0b713127246ebac5083d2263e2a_8.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p>普通支气管镜无法进入外周支气管</p></section></section></section><section powered-by="gulangu"><section><section><p><strong><span>经皮穿刺</span></strong>：医生在CT扫描的引导下，用细针刺入病变部位，提取组织样本进行诊断。虽然诊断效果不错，但也有很高的并发症风险。<span>42%的经皮穿刺会造成气体进入胸膜腔，引发致命的气胸，出血和溶血的几率也高达10%</span>。如果穿刺针把肿瘤细胞带到其他部位，还会导致危险的种植感染。</p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>有的患者求治心切，也会选择<span>直接进行切除手术</span>，开胸切肺的手术会给身体带来极大的伤害，<span>本就不适合身体脆弱的患者，更有20%到45%的可能会切除本就没有病变的部位</span>，导致过度治疗。</p><p><br  /></p><p>如果病变的体积小，生长的位置或患者的身体条件又不适合活检和切除，患者也会被推荐<span>等待观察</span>。这无异于在身体里埋下了一颗不定时炸弹，<span>不仅会延误潜在的病情，也会让患者惶惶终日、无法安宁</span>。</p><p><br  /></p><p>不论是支气管镜、穿刺活检、手术切除或被动等待，没有一种方法能同时准确而安全地诊断早期肺癌。难道就没有一种更好的方法，能揪出潜藏在支气管迷宫里的病变吗？</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/4eaad58972053f89df0ff9c39dc20833_9.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>谁都不会想到，最初找到答案的，竟然是一家玩具公司。</p><p><br  /></p><p>1995年，一位名叫Pinchas Gilboa的以色列人创办了superDimension公司。Pinchas Gilboa曾为以色列国防部设计电磁导航系统，他的梦想是用这种技术来制作智能玩具。</p><p><br  /></p><p>但Gilboa的伙伴却始终觉得，把这么高端的技术用在玩具上好像有点太过于大材小用了。于是在卖了三年玩具后，superDimension开始寻找能让电磁导航技术发挥更大价值的领域。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p>经过几年的波折和调整，<span>这家毫无医疗背景的玩具公司，凭借前沿的军事科技，在肺癌诊断领域找到了立足之地，推出了全球首款电磁导航支气管镜系统。<span>5</span></span></p></section></section></section></section><section><section powered-by="gulangu"><section><p><img src="image/20201014/6b42beabc71609ae2d5414ed9252a174_10.jpg" /></p></section></section></section></section></section><section powered-by="gulangu"><section><section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>就像普通导航软件的路径规划和实时导航功能一样，电磁导航支气管镜由术前计划和术中导航两大系统组成。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section></section></section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><img src="image/20201014/1b13f6642c3956f967de68f89394a033_11.jpg" /></p></section></section></section><section><section powered-by="gulangu"><section><section><p><strong>术前计划系统：</strong></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><span>与导航软件绘制路线图相似，电磁导航支气管镜在CT扫描数据的基础上，利用三维CT成像技术<span>建立肺部的三维模型</span>，再利用虚拟支气管镜技术，在支气管的迷宫里<span>规划出一条通向病灶的清晰路线<span>。</span></span></span></p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/9bdde4358f290a509c2672f3698a5c5a_12.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><img src="image/20201014/3a4b05c84d63d1f9011dbf71042af66d_13.jpg" /></p></section></section></section><section><section powered-by="gulangu"><section><section><p><strong>术中导航系统：</strong></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>开车的时候，司机可以通过GPS卫星定位系统实时获知自己的位置。在手术过程中，患者躺在电磁定位板上，处于微弱的磁场中。当定位导向管进入患者的肺部，<span>导向管前端的电磁感应探头和磁场相呼应，可以向医生实时反映探头在三维空间的位置和方向</span>。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/d26dee47304bdcda076f796ad7f14dca_14.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p>医生对照虚拟路径置入定位导向管</p></section></section></section><section powered-by="gulangu"><section><section><p>这时候，医生只需操作手柄，就能驱使定位导向管在错综复杂的支气管网络里穿行。导向管的直径不到2毫米，末端能够360度旋转，可以到达肺部最深处的病灶。</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/883a66e4287df9a36a200204d66468bf_15.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p>探头可以进入外周支气管到达病灶</p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>简单来说，电磁导航支气管镜就像是安装了GPS系统的气管内镜，具备实时定位导航和全肺无创到达的优势，让复杂的支气管网络几乎不存在无法到达和诊断的盲区。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/ef087352c543d76b72f9bbdc96451165_16.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/991c53f16d18966ed0d463f6e615c791_17.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>当定位导向管到达病灶时，一条直通病灶的通道就真正建立起来了。</p><p><br  /></p><p>隐藏在支气管迷宫深处的凶手失去了保护屏障，<span>医生不仅可以利用这条通道取出病变组织进行活检，还能进行组织标记、微创治疗，把疾病扼杀在萌芽阶段。</span></p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section></section></section><section><section powered-by="gulangu"><p><p><img src="image/20201014/8d84cf25873ef36afc2369de23ae8325_18.jpg" /></p></p></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><span>就像万能的瑞士军刀一样，<span>电磁导航支气管镜开拓出一条精准诊疗肺癌的多功能通道，彻底改变了早期肺癌的诊断和治疗方式。</span>如今，superDimension电磁导航支气管镜已经在全球开展了约15万例手术，<span>对外围支气管病灶的诊断率高达80%-89%。医学界认为，这项技术有望大幅延长全球肺癌患者的生存时间。<span>6</span></span></span></p><p><span><br  /></span></p><p>2012年，superDimension公司被柯惠收购，并在2015年随柯惠来到美敦力。目前这款前沿技术已经进入中国17个城市的23家医院，有望为中国的肺癌患者带来颠覆性的诊断和治疗效果。</p></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/4aca3da899c5ff20e818b68df0855e06_19.jpg" /></p></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><strong>电磁导航支气管镜入驻城市名单</strong>：广州，深圳，重庆，成都，上海，杭州，苏州，南京，济南，青岛，哈尔滨，沈阳，大连，西安，北京，武汉，郑州</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section></section><section></section><section><section><section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p>在电磁导航系统的帮助下，比重庆高架桥还要复杂的支气管迷宫终于被破解，让肺癌的诊断和治疗有了更加微创、安全、精准的方法。对于广大肺癌患者来说，这不仅仅是一条指向疾病隐患的通路，更是一条通向生命和未来的大道。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>点击视频，了解更多电磁导航支气管镜的信息</p><p>（建议在wifi条件下观看）</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><iframe src="https://v.qq.com/iframe/player.html?vid=i0546pwfgrk&auto=0" width="100%" height="580" frameborder="0"></iframe><br  /></section></section></section></section></section><section powered-by="gulangu"><section><section><p><p><img src="image/20201014/c6824627db398442d6c052c8b6425f71_20.png" /></p></p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>[1] GLOBALCAN 2012.</p><p>[2] 我国肺癌发病率每年增长26.9% 仍继续迅速上升，北京日报</p><p>[3] 原发性支气管肺癌早期诊断中国专家共识</p><p>[4] superDimension innovation brochure. Medtronic.</p><p>[5] Nancy Dvorin. superDimension: Guided Bronchocopy to the Lung’s Periphery. 2005</p><p>[6] Re-thinking technology. Medtronic.</p></section></section></section></section><p><br  /></p><p><span><em><span>转自美敦力</span></em></span></p><p><span><em><span></span></em></span></p><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><p><span><strong>相关阅读</strong></span></p></section><p><p><img src="image/20201014/ec237188ae1e9c03eb4d9814f31b18ab_21.gif" /></p></p><p><span>『大开眼界』美敦力的行业"霸主"秘籍</span></p><p><span>得了肺癌是不是就没救了？</span></p><p><span>关于肺的那些事......</span></p><p><span>最美动图——关于我们奔腾的心！</span></p><p><span>首部心梗防治微电影，1次转发可能挽救1条生命</span></p><p><span>【大时代】2015-2020全球医疗器械市场，美敦力将称霸？</span></p></section></section></section></section></section></section></section></section></section></section></section><p><br  /></p><p><span><p><img src="image/20201014/da0d101cb2763cefb61f8120386ec54a_22.png" /></p></span></p>