新型心脏外科手术模拟训练系统的设计与评估  

The design and assessment of a novel simulated training system for cardiac surgery

作　　者：梁世超 宋成利[1] 赵雪松 马昶 李显达 刘沙 LIANG Shichao;SONG Chengli;HAO Xuesong;MA Chang;LI Xianda;LIU Sha(Shanghai Institute for Minimally Invasive Therapy,School of Medical Instrument and Food Engineering,University of Shanghai for Science and Technology,Shanghai 200093,P.R.China;Shanghai Shinno-Med Technology Co.Ltd.,Shanghai 200093,P.R.China;CCI,Covidien（Shanghai）Management Consulting Co.Ltd,Shanghai 200093,P.R.China)

机构地区：[1]上海理工大学医疗器械与食品学院教育部微创医疗器械工程研究中心,上海200093 [2]上海世恒医学科技有限公司,上海200093 [3]柯惠(上海)企业管理顾问有限公司,上海200093

出　　处：《生物医学工程学杂志》2018年第5期779-785,共7页Journal of Biomedical Engineering

基　　金：国家自然科学基金项目(No.51735003)

摘　　要：手术训练系统可以模拟手术环境,提高受训人员的操作技能。本文设计了一种新型的心脏外科手术模拟训练系统,并选择离体猪心脏作为心脏外科手术模拟训练系统的心脏模型,通过设计机械运动装置来实现心脏模型的跳动,同时可调整机械结构运动的频率来改变心脏模型的跳动频率。为验证该系统的合理性,将12名非医学专业学生与12名医学专业学生分为两组,使用心脏外科手术模拟训练系统进行为期7 d的不停跳冠脉搭桥手术训练,记录受训人员训练前后完成搭桥的时间,并由3名外科医生采用对象结构评价技能(OSATS)评估标准对每名学员的冠脉搭桥手术训练结果进行评分。通过训练,两组受训人员完成搭桥缝合的时间均显著缩短,训练前后的OSATS评分均得到提高。结果表明,心脏外科手术模拟训练系统在提高受训人员手术技巧、操作技能、掌握手术器械的使用等方面具有较好的训练效果。Simulations can mimic the environment that refers to the surgery operation to improve the technical skills of the trainees.In this paper,we designed a new cardiac surgery simulative training system.The isolated pig heart was selected as the heart model.A mechanical device was designed to achieve the beating of heart model.At the same time,adjusting frequencies of mechanical movement could change the rating of heartbeat.In order to validate the rationality of the system,12 non-medical specialty students and 12 medical specialty students were divided into two groups,which consecutively accepted seven-days of training for off-pump coronary artery bypass grafting using the cardiac surgery simulative training system.The time for completing bypass grafting before and after training were recorded.And the bridging outcomes of each trainee were assessed by 3 surgery cardiac surgeons using the object structured assessments of technical skill（OSATS） criteria.After training,each trainee could finish the bypass suturing in a shorter time than before training,and the scores of each trainee assessed by OSATS criteria were also improved.The results showed that the cardiac surgery simulative training system had better training effect in improving the surgical techniques,operation skills and proficiency of surgical instruments of trainees.

关 键 词：心脏外科 冠脉搭桥手术 模拟与仿真 训练与评价 

分 类 号：R654.2[医药卫生—外科学]