虚拟膝关节镜系统培训临床医生的手术技能*☆

摘要

BACKGROUND: Virtual knee arthroscopy system has achieved some preliminary research results at home and abroad, but it is stil unable to be popularized and applied widely because of the high cost. Therefore, we designed a set of simulation endoscopic equipment, which al ows the surgeons to promote surgery skil s during virtual surgery. OBJECTIVE: To evaluate the training effect of virtual knee arthroscopy system on surgical skil s of the beginning students. METHODS: Twenty-four interns and orthopedists (16 interns with no arthroscopy operating experience; eight experts with arthroscopy operating experience) were selected from five different universities and different hospitals, and 16 interns were randomly divided into training group and control group, eight interns in each group. After system training, the training group was compared with the control group and expert group in the virtual knee arthroscopy system operation and clinical surgery operation, and the results were statistical y processed. RESULTS AND CONCLUSION: In the virtual endoscope system operation, there was significant difference in the scores between the control and training groups (P < 0.001), and also between the control and expert groups (P <0.001); however, there was no significant difference in the scores between the training and expert groups (P=0.115). In the clinical knee arthroscopy operation, there were significant differences between the training and control groups (P <0.001), between the control and expert groups (P < 0.001), and between the training and expert groups (P=0.03). Virtual knee arthroscopy system can serve as beneficial surgery skil training for beginning students and the improvement of virtual operation technique may be related to clinical skil s.%　　背景：虚拟膝关节镜系统在国内外已有初步的研究成果，但价格比较昂贵，目前还无法得到推广应用，有鉴于此，作者设计、开发了一套虚拟内镜仿真设备，它可以让外科医生运用模拟手术操作器械在虚拟的关节腔环境中进行手术，获得训练效果。目的：评估本虚拟关节内镜系统对关节镜外科初学者的手术技能训练效果。方法：选择来自5所不同大学的实习医生和不同医院的医生24名，其中无关节镜操作经验的实习医生16名，有关节镜操作经验的专家8名，16名实习医生随机分为受训组和未受训组，每组各8名。在对受训组进行系统培训之后，使其分别在虚拟关节镜系统操作中和临床手术操作中与未受训组以及专家组作对比；将对比结果进行统计处理。结果与结论：在虚拟内镜系统操作中：未受训组与受训组人员之间的得分差异有显著性意义(P <0.001)；未受训组与专家组之间差异有显著性意义(P <0.001)；而受训组与专家组之间的差异无显著性意义(P=0.115)。在临床关节内镜手术操作中，未受训组和受训组人员之间差异有显著性意义(P <0.001)；未受训组成员与专家组成员之间差异有显著性意义(P <0.001)；受训组与专家组之间差异有显著性意义(P=0.03)。表明虚拟关节镜系统对初学者的手术操作技能起到良好的培训效果。同时也表明虚拟手术操作技能的提高与临床操作技能的提高具有一定的相关性。