手术中的人工智能系统：能力、局限和前景。 文献综述

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详细

如今，人工智能系统越来越多地应用于医学的各个领域。通过对eLibrary、PubMed、Medline、WoS、 Nature、Springer、Wiley J Database中1985-2023年间的278篇出版物进行的分析，选出了99篇文章。这些文章介绍人工智能方法和技术在儿科手术和重症监护中应用的主要方法和现状。本文涉及医用人工智能系统的各种各样方面。这些系统主要是计算机医疗决策支持系统或外科手术干预过程中的外科医生助手。可以通过计算机分析三维成像、计算机断层扫描和磁共振成像的三维解剖建模来规划手术。有了足够精确的三维模型以及器官和病理过程的可视化方法，就可以开发出一系列用于术前规划和术中支持手术干预的技术和软件工具。计算机（技术）视觉允许对医学图像进行高质量的分析，在多模态三维图像中及在视觉控制下的手术过程中对其进行解读（以用于计算机诊断）和，包括增强现实方法。机器人手术涉及机械手（包括遥控机械手）和智能综合体。这些综合体参与手术，并自主执行“第二辅助外科医生”的某些操作。重症监护领域的人工智能技术正在考虑将床边监护仪的数据和其他病人信息结合起来，以识别危急情况并控制肺通气支持。与此同时， 人工智能在外科手术中的应用还受到一些因素的制约。这些因素包括：组合所需的初始数据的性质和标准化、对非典型病例的考虑、所用样本存在偏差的风险以及机器学习模型决策过程的透明度。人工智能系统的开发和应用前景取决于机器学习模型中提出的决策可解释性，以及向所创建系统的全面验证。

作者简介

Boris A. Kobrinskii

Federal Research Center «Computer Sciens and Control» Russian Academy of Sciences

编辑信件的主要联系方式.
Email: kba_05@mail.ru
ORCID iD: 0000-0002-3459-8851
SPIN 代码: 7075-7784

PhD, Dr. Sci. (Med.), Professor, Honored Scientist of the Russian Federation; Head of the Department of Intelligent Decision Support System; Chairman of the Scientific Council of the Russian Association of Artificial Intelligence

俄罗斯联邦, Moscow

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