三维可视化及虚拟手术技术在住院医师肝脏手术规范化培训中的作用  

Utility of three-dimensional visualization and virtual surgery in liver resection surgery teaching for residents

作　　者：韩少山[1] 宋涛[1] 姚英民[1] 刘青光[1] 韩蕾 Han Shaoshan;Song Tao;Yao Yingmin;Liu Qingguang;Han Lei(Department of Hepatobiliary Surgery,the First Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710061,China;Department of Microbiology and Immunology,School of Basic Medical Sciences,Health Science Center,Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,西安710061 [2]西安交通大学医学部基础医学院病原生物学与免疫学系,西安710061

出　　处：《中国医学教育技术》2021年第5期641-646,共6页China Medical Education Technology

摘　　要：目的探讨三维可视化及虚拟手术技术在住院医师肝脏手术规范化培训教学中的作用及效果。方法选取西安交通大学第一附属医院肝胆外科的40名住院医师(包括规范化培训住院医师、进修医师及该院医师)作为研究对象,随机分为对照组(n=20)和试验组(n=20)。对照组采用传统的肝脏解剖、手术图谱及二维的CT或MRI图像进行手术规划及手术路径制定的教学;试验组采用重建软件生成的肝脏三维重建可视化模型及虚拟手术模块,结合高清手术录像进行教学。教学结束后对两组住院医师进行考核评分,评价其手术规划能力及对手术路径的理解力,最后进行问卷调查,评价住院医师对教学方法的体会及满意度。结果试验组手术规划及手术路径理解的考核总得分为(7.450±1.468)分,显著优于对照组的(4.950±1.146)分,差异具有统计学意义(P<0.01);试验组对肝脏病变与肝动脉、门静脉、肝静脉、胆道关系的判断正确率显著高于对照组,试验组制定的切肝平面准确率显著高于对照组(P<0.01)。试验组对肝脏外科手术教学的兴趣及满意度显著高于对照组(P<0.05)。结论采用三维可视、虚拟手术技术进行住院医师肝脏外科手术教学,可显著提升住院医师对复杂肝脏手术的术前规划能力和对手术路径的理解能力,值得推广。Objective To explore the utility and effect of three-dimensional visualization and virtual surgery in the liver surgery teaching for residents.Methods 40 residents(including standardized training residents,doctors in advanced studies as well as doctors from this hospital)from the department of hepatobiliary surgery of the First Affiliated Hospital of Xi'an Jiaotong University were randomly divided into the control group(n=20)and the experimental group(n=20).The control group used traditional liver anatomy,surgical atlas and two-dimensional CT or MRI images for liver resection surgery teaching,while the experimental group used 3D reconstruction visualization model and virtual operation module generated by reconstruction software,as well as high-definition surgical video for teaching.After the teaching,residents of the two groups were assessed and scored,and their operation planning ability and understanding of the operation protocol were evaluated.Finally,a questionnaire survey was conducted to evaluate the residents'experience and satisfaction with the teaching.Results The total score of surgical planning and understanding of operation protocol in the experimental group was(7.450±1.468),which is significantly higher than that of the control group(4.950±1.146)(P<0.01).The correct rate of judging the relationship between liver lesions and hepatic artery,portal vein,hepatic vein,and bile duct in the experimental group was significantly higher than that in the control group.The accuracy of hepatectomy plane established by residents in the experimental group was significantly higher than that in the control group(P<0.01).Residents in the experimental group were significantly more interested in and satisfied with the teaching of liver surgery than those in the control group(P<0.05).Conclusion The use of three-dimensional visualization and virtual surgery technology in the teaching of liver surgery significantly improved residents'ability of preoperative planning and understanding of complex liver surgery,and is worth

关 键 词：肝脏手术 三维可视化 虚拟手术 手术教学 

分 类 号：G434[文化科学—教育学] G642.0[文化科学—教育技术学]