摘要:
目的 探讨动物皮肤和人工皮肤在临床技能模拟训练中的应用效果.方法 选择2018年在北京医院进行第一年住院医师规范化培训的48名学生为研究对象,按照随机数字表法将其平均分为动物皮肤组和人工皮肤组,每组24人,分别完成规则伤口缝合(站1)、不规则伤口缝合(站2)、深部伤口缝合(站3)的学习和测评.使用客观结构化技能评估(objective structured assessment of technical skills,OSATS)对学生的技能和总体表现进行测评.分别调查10个动物皮肤和10个人工皮肤的使用寿命.结果 动物皮肤组站1成绩为(14.8±2.1)分,人工皮肤组站1成绩为(14.6±1.8)分,两组差异无统计学意义(P=0.666);动物皮肤组站2成绩为(13.9±1.9)分,人工皮肤组站2成绩为(12.1±2.1)分,两组差异具有统计学意义(P<0.01);动物皮肤组站3成绩为(12.8±2.0)分,人工皮肤组站3成绩为(11.4±2.1)分,两组差异具有统计学意义(P=0.03).动物皮肤的使用寿命为(4.5±1.2)小时,人工皮肤的使用寿命为(13.5±2.6)小时,两者差异具有统计学意义(P<0.01).结论 动物皮肤和人工皮肤在规则伤口缝合训练中的效果无明显差异,在不规则伤口和深部伤口的缝合训练中,动物皮肤优于人工皮肤,人工皮肤使用寿命更长.%Objective To evaluate the effect of animal skin and artificial skin in clinical suture skills training. Methods Forty-eight medical students who received standardized training were enrolled in this study. The students were asked to perform 3 suturing tasks on the animal skins or artificial skins:neat wound suture ( station 1);irregular wound suture ( station 2);deep tissue suture ( station 3) . The skill and general performance were assessed by the objective structured assessment of technical skills ( OSATS ) scoring tool. The service lives of 10 animal skins and 10 artificial skins were investigated. Results In station 1,the scores were 14. 8±2. 1 in animal skins group and 14. 6±1. 8 in artificial skins group,there was no statistical difference between the two groups (P=0. 666). In station 2,the scores were 13. 9±1. 9 in animal skins group and 12. 1± 2. 1 in artificial skins group, and the score of animal skins group was significantly better than that of artificial skins group (P<0. 01). In station 3, the scores were 12. 8±2. 0 in animal skins group and 11. 4±2. 1 in artificial skins group, and the score of animal skins group was better than that of artificial skins group (P=0. 03). The service life of animal skin was (4. 5±1. 2)hours, and that of artificial skin was (13. 5±2. 6) hours. The difference was significant (P<0. 01). Conclusions In neat wound,the suture skills training in animal skins and artificial skins have the same effect. In suture training of irregular wound and deep tissue, the animal skins are better than artificial skins.