3D打印腹主动脉瘤模型在规培住院医师血管外科轮转教学中的应用

摘要

Objective To evaluate 3D printing abdominal aortic aneurysm model in analysis of clinical teaching effect for standardized resident doctors in vascular surgery department. Methods 48 resi-dents in vascular surgery department in our hospital from December 2016 to September 2017 were seleeected and randomly divided into control group and the experimental group. The traditional vascular surgical anatomy atlas, ultrasound, CT abdominal blood vessel 3D reconstruction, digital subtraction, video and so on were used by 24 residents in the control group, while in the experimental group, on the basis of the traditional teaching, abdominal aortic aneurysm model of 3D printing, true aortic coated stent delivery system were increased. After the teaching, the theory of evaluation (abdominal vascular anatomical features, morphological characteristics and classification of AAA, measurement of various parameters and key points of operation in the EVAR) and satisfaction questionnaire were adopted to evaluate the effect of two kinds of teaching methods. SPSS 19.0 was used to conduct t test on two groups of physician evaluation data. Results The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the abdominal vascular anatomical features, the morphological features and the classification of the experimental group (P>0.05) in the examination of the common AAA cases and the complicated AAA cases. However, the experimental group was higher than the control group in the mea-surement of the parameters of EVAR, and the score of the operation points and the total score, and the difference was statistically significant (t=2.283, t=2.263, P<0.05). The results of the questionnaire showed that the students' satisfaction scores on the teaching satisfaction of the normal and complex AAA cases were better than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The 3D printing model can increase the understanding and mastery of the anatomy and treat-ment of abdominal aortic aneurysm and improve its learning enthusiasm for vascular surgery. We should make full use of the advantages of 3D printing technology on the basis of retaining the advantages of tradi-tional teaching methods and means, and further enhance the teaching effect.%目的 评估3D打印腹主动脉瘤模型在规培住院医生血管外科轮转教学中的应用效果.方法 2016年12月至2017年9月选取48位在我院血管外科轮转的规培住院医师,随机分为对照组及实验组.对照组24人,采用传统的血管外科解剖图谱、超声、CT腹部血管三维重建、数字化血管减影、视频等资料对其进行教学.实验组24人,在上述传统教学的基础上增加应用腹主动脉瘤3D打印模型,并结合主动脉覆膜支架输送系统模型.待教学结束后,分别采用两次三部分形式理论考核(腹部血管的解剖学特点,AAA的形态特症及分类,EVAR中各项参数的测量及手术要点)和满意度问卷调查来评价两组教学效果.采用SPSS 19.0对两组医师考评数据行t检验.结果 理论考核结果显示,普通AAA病例及复杂AAA病例考核中,对照组及实验组学员在腹部血管解剖学特征、分型的形态学特征及分类上成绩差异无统计学意义(P>0.05);但在腹主动脉瘤腔内覆膜支架修复术(EVAR)各项参数测量及手术要点得分和总成绩方面,实验组学员高于对照组,差异有统计学意义(t=2.283,t=2.263,P<0.05).问卷结果显示,实验组学员对普通和复杂AAA病例的教学满意度评分,均优于对照组,差异具有统计学意义(P<0.05).结论 3D打印模型能够增加血管外科住院医师对腹主动脉瘤解剖、治疗的理解度及掌握度,提高其对血管外科的学习积极性.应在保留传统教学方式和手段优点的基础上,充分利用3D打印技术的优势,进一步提升教学效果.