超声引导下羊膜腔内胎儿脐静脉穿刺模型的建立  

Establishment of a model for ultrasound-guided amniocentesis and cordocentesis

作　　者：吕述彦[1] 盛文伟[2] 程金红[1] 陈晓琴[1] 王旭菲[2] 许敏[1] 

机构地区：[1]南京医科大学附属淮安第一医院产科,江苏淮安223300 [2]南京医科大学附属淮安第一医院超声科,江苏淮安223300

出　　处：《现代预防医学》2015年第6期1012-1014,1041,共4页Modern Preventive Medicine

基　　金：淮安市科技计划项目(HAS2011029)

摘　　要：目的经超声引导下的胎儿脐静脉穿刺技术是产前诊断与胎儿宫内疾病诊断与治疗的主要技术,但手术风险较大。本篇设法用刚从母体娩出的胎盘、脐带、橡胶手套等材料制作一种方法简便,价格低廉,更能模拟真实情况的实体模型,用来训练操作者的空间立体感、手眼协调能力及穿刺技能。方法选择刚从母体娩出的胎盘、脐带、猪皮、8号橡胶手套、细皮条、自来水、容器等材料来制作一种模拟中晚期妊娠宫内环境的实体模型。用充满自来水的水囊模拟羊膜腔环境、胎盘附着在水囊壁、连接胎盘的脐带漂浮于水囊内,脐静脉就作为操作者的穿刺目标。结果用胎盘、脐带、橡胶手套等材料制作的模型,可以为操作者提供更为逼真的胎儿脐静脉穿刺术练习场景,培养操作者的穿刺技能:如超声介导下实时监控穿刺针的进退、穿刺方向与深度、穿刺目标的准确性,更好地培训穿刺者的手眼协调能力与操作技能。结论本模型能为操作者提供胎儿脐静脉穿刺技术更逼真的穿刺场景与培训工具。Objective Ultrasound-guided fetal cordocentesis is the main technology with high surgical risks in prenatal diagnosis and treatment of fetal diseases. In this study, a simple and cost-effective amnio-trainer model that reproduces real life conditions was made by various materials including the placenta just delivered from a mother, umbilical cord and the rubber gloves for the operators to practice stereotactic skills, hand-eye coordination and puncture skills. Methods Placenta that just delivered from the mother, umbilical cord, pig skin, the 8thrubber gloves, creance, tap water, container and other materials were made into the model that simulates intrauterine environment of mid-trimester and late pregnancy. Water sac was filled with tap water simulating amniotic cavity environment. Placenta was attached to the wall of water sac. Umbilical cord was connected onto placenta floating in water sac.The umbilical vein was the target of practice for the operator. Results The model made by placenta, umbilical cord, rubber gloves and other materials could provide the operator with a more realistic practice scenario of fetal umbilical vein puncture, and be very helpful to improve the operator＇s puncture skills, such as ultrasound-mediated real-time monitoring the retreat of the puncture needle, controlling the direction and depth of the puncture needle, and accurately targeting the puncture. This model could also improve the operator＇s hand-eye coordination. Conclusion This model can provide the operator with a more realistic training scene and serve as a good training tool for fetal umbilical vein puncture.

关 键 词：羊膜腔穿刺术 脐静脉穿刺 超声检查 

分 类 号：R714.5[医药卫生—妇产科学]