冠脉搭桥专项手术技能培训新模式在研究生教育中的应用探讨  

An exploration of the application of a new training mode of special coronary artery bypass grafting in postgraduate education

作　　者：崔永春[1] 李波 罗富良[1] 袁卫民[1] 罗晓康 祁磊 李彬[1] 唐跃[1] Cui Yongchun;Li Bo;Luo Fuliang;Yuan Weimin;Luo Xiaokang;Qi Lei;Li Bin;Tang Yue(Center for Cardiovascular Experimental Study and Evaluation,Fuwai Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases/State Key Laboratory of Cardiovascular Disease/Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials,Beijing 100037,China)

机构地区：[1]北京协和医学院/中国医学科学院阜外医院心血管在体实验及评价中心/国家心血管病中心/心血管疾病国家重点实验室/心血管植入材料临床前研究评价北京市重点实验室,100037

出　　处：《中华医学教育探索杂志》2019年第2期172-176,共5页Chinese Journal of Medical Education Research

摘　　要：目的探讨"理论授课-离体-在体-总结-离体-在体-考核"双循环强化训练模式(dual-cycle intensive training mode,DCITM)相对于传统"理论授课-离体-在体-考核"单循环基础训练模式(basic training mode,BTM)在心血管外科专业学位研究生手术基本技能培训中的效果。方法8名心血管外科专业在读研究生依次接受BTM和DCITM小班冠脉搭桥血管吻合术基本技能培训,然后以专家评分方式对培训效果进行评价,采用SPSS17.0统计软件对评价结果进行分析。结果与BTM比较,DCITM培训出来的研究生手术技术更加娴熟。在小型猪离体心脏冠脉吻合中,规定时间内人均完成吻合口数量明显增加[(2.0±1.0)vs.(5.0±1.5),P<0.05],血管渗漏率明显降低[(92±5)%vs.(30±2)%,P<0.05],每个吻合口的平均用时明显缩短[离体:(20.1±2.5)minvs.(12.6±3.3)min,P<0.05];而在小型猪在体冠脉血管吻合中,不同方法培训后每个吻合口的平均用时差异也有统计学意义[在体:(30±2)minvs.(21±3)min,P<0.05]。结论DCITM是一种值得推广的高效优化心血管外科专业研究生教育教学质量、增强临床手术技能训练效果的模式。Objective To compare the effects between the dual-cycle intensive training mode(DCITM)of "teaching-in vitro-in vivo-summary-in vitro-in vivo-assessment" and the single-cycle basic training mode(BTM)of "teaching-in vitro-in vivo-assessment" on training graduate students majoring in cardiovascular surgery.Methods Eight graduate students majoring in cardiovascular surgery received the basic training of coronary artery bypass vascular anastomosis under the mode of BTM or DCITM.Then the training effects were evaluated by scoring of experts.Besides,SPSS 17.0 statistical software was used to analyze the evaluation results.Results Compared with students who received BTM,the postgraduates trained by DCITM became more skilled in vascular anastomosis.In vitro,the average number of anastomosis completed by trainee increased significantly [(2.0±1.0)vs.(5.0±1.5),P<0.05] over a specified period of time,the vascular leakage rate was significantly reduced [(92±5)% vs.(30±2)%,P<0.05],and the average time per anastomosis was significantly shorter [in vitro:(20.1±2.5)min vs.(12.6±3.3)min,P<0.05].There was also a statistically significant difference in the average time of each anastomosis in miniature pigs with coronary vascular anastomosis [in vivo:(30±2)min vs.(21±3)min,P<0.05].Conclusion Taken into together,DCITM is a highly efficient mode for promoting the quality of cardiovascular-surgery-teaching and enhancing the effectiveness of training in clinical surgical skills.

关 键 词：心血管外科学 临床研究生 培养模式 

分 类 号：R445[医药卫生—影像医学与核医学]