注意力分散对白内障手术操作的影响  

Effect of distraction on simulated surgical cataract performance

作　　者：郭亚雯[1] 路承喆[1] 宋慧[1] 苑晓勇[1] 汤欣[1] 

机构地区：[1]天津市眼科医院,天津医科大学临床眼科学院,天津市眼科与视觉科学重点研究室,天津300020

出　　处：《中国实用眼科杂志》2013年第11期1455-1458,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨利用Eyesi模拟操作系统，评价具有不同手术经验的医师在注意力分散时，对其显微手术基本操作和白内障超声乳化手术操作的影响。方法实验研究。选取住院医师26人，为低年资组；高年主治医师及以上医师15人，作为高年资组。两组分别在注意力集中和注意力分散的情况下进行10次连续环形撕囊模拟操作。系统会自动得出每次操作所用时间、以及综合评价周围组织损伤程度、囊口位置、形态和大小的操作得分，将两组测试结果进行比较。结果高年资组在注意力集中和分散模式下，撕囊成功率的比较，差异没有统计学意义；撕囊成功所用时间的比较差异有统计学意义。低年资组在注意力集中和分散模式下，撕囊成功率和撕囊成功所用时间的比较差异均有统计学意义。结论注意力分散对于经验不足的术者，既会影响其白内障手术操作的效果，也会延长其操作时间。但对于经验丰富的手术者而言，注意力分散只会影响其白内障手术操作所用时间而不会影响手术效果。Objective To evaluate the effect of distraction on continuous circular capsulorhexis （CCC） skill performance using a virtual reality simulator in expert and novice surgeons. Methods Ex- pert （n =15） and novice （n =26） ophthalmic surgeons completed a standardized and validated surgical task l0 times on a virtual reality simulator （EyeSi）. They then completed a dual task （cognitive task with arithmetic questions）, after which they completed 10 attempts （take the last 5 attempts only） on the same module simulator module. The system would automatically evaluate the time of each proce- dure, the score of injuries of the surrounding tissue, the location, the form and size of the capsule and the mistakes during the procedure. Finally, results of the two groups were calculated with SPSS17. Results For experts, the difference between the Single Tasking and Dual Tasking was statistically sig- nificant only in the operation time. As for novice the score and time in CCC as well as the success rate of CCC, there was statistical significance between the single tasking and dual tasking. Conclu- sions A distractive cognitive task reduces the ability of novice surgeons to deal with that cognitive task. For experts, a distractive cognitive task doses not reduce their simulated surgical performance.

关 键 词：白内障 超声乳化 连续环形撕囊 模拟器 

分 类 号：R779.66[医药卫生—眼科]