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精准控制与智能定位机器人系统在鼻空肠营养管置管技术中的思考与展望

Thoughts and Prospects on Precision Control and Intelligent Positioning Robotic Systems Applied in Nasojejunal Feeding Tube Placement

  • 摘要: 鼻空肠营养管广泛用于外科手术、重症监护及老龄患者。鼻空肠营养管人工盲插置管操作难度大,失败率高,易造成并发症。人工后端推进与患者状态协调过程交互作用力的不确定性和弱可控性是置管效果不佳的主要原因。当前,在X射线、超声、内镜等技术手段辅助下,能一定程度提升鼻空肠营养管置入成功率,降低置管并发症。但是,置管准确性、安全性仍受制于置管操作力的控制和位置定位精度。机器人有望依靠精确感知、实时导航与高效控制,解决置管过程不确定和弱可控难题,通过智能定位精准控制导管前端的行进方向和位置。然而,当前机器人技术在鼻空肠营养管置管应用的研究尚处于起步阶段,仍面临高成本、操作复杂、安全与可靠性不足等问题。本文分析了现有置管方法局限性与失败原因,探讨了精准控制与智能定位机器人技术在鼻空肠营养管置管操作中的应用前景,为研发安全、有效、舒适、快速置管的护理技术研发提供新思路。未来,应深化人工智能与机器人技术的融合,优化驱动技术,加速技术从实验向临床转化,推动鼻空肠营养管置管技术向智能化、精准化、普惠化方向发展。

     

    Abstract: Nasojejunal feeding tubes are widely used in surgical, intensive care, and older patients. Manual blind insertion of nasojejunal feeding tubes is technically challenging, associated with a high failure rate, and prone to complications. The primary causes of suboptimal placement outcomes are the uncertainty and weak controllability of the interaction forces during the coordination between manual posterior advancement and the patient's physiological state. While current auxiliary techniques such as X-ray, ultrasound, and endoscopy can improve the success rate of nasojejunal tube placement and reduce complications to some extent, the accuracy and safety of placement remain constrained by challenges in controlling insertion forces and achieving precise positional localization. Robotic technology holds promise for addressing the uncertainties and controllability issues inherent in the placement process. By leveraging precise sensing, real-time navigation, and efficient control, robots can achieve intelligent positioning and precise control over the direction and location of the catheter tip during nasojejunal intubation. However, current research on robotic applications for nasojejunal feeding tube placement is still in an early stage, facing challenges such as high costs, operational complexity, and concerns over safety and reliability. Herein, we analyzed the limitations and causes of failure in existing placement methods and explored the application prospects of robotic technologies for precise control and intelligent positioning in nasojejunal feeding tube placement. The paper provides new insights for developing nursing techniques that enable safer and more effective, comfortable, and rapid intubation. Future efforts should focus on deepening the integration of artificial intelligence and robotics, optimizing drive technologies, and accelerating the translation of these technologies from the laboratory to clinical practice. This will drive the advancement of nasojejunal feeding tube placement techniques towards intelligent, precise, and accessible solutions.

     

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