EyeSi模拟手术训练系统对专科医师白内障手术操作培训有效性的研究  

Effectiveness of EyeSi simulated surgery training system in cataract surgery training for ophthalmologists

作　　者：刘子源[1] 曾司彦 敖明昕[1] 王薇[1] 孙岩秀[1] Liu Ziyuan;Zeng Siyan;Ao Mingxin;Wang Wei;Sun Yanxiu(Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科,100191

出　　处：《眼科》2022年第5期390-393,共4页Ophthalmology in China

基　　金：北京大学医学部专科医师培训研究课题(2019ZP37)。

摘　　要：目的评价虚拟现实模型EyeSi白内障超声乳化手术训练系统(EyeSi系统)在眼科专科医师白内障手术培训中的应用效果。设计自身对照研究。研究对象北京大学第三医院眼科专科培训医师10人。方法使用EyeSi系统进行白内障显微手术培训并记录撕囊步骤的评分;由5名白内障专业高级职称手术医师对研究对象培训前和培训后的手术录像按照国际眼科理事会眼科手术能力评估标准(ICO-OSCAR)进行盲法打分,比较培训前、后撕囊步骤成绩;学员填写自我评价量表。主要指标EyeSi系统评分、专家评分、自我评价量表分值。结果EyeSi系统成绩显示培训后撕囊半径均一性由(24.51±30.58)%提高为(95.90±7.00)%(t=-7.600,P=0.000),提示撕囊更圆;撕囊偏离中心的距离由(0.38±0.14)mm减小为(0.11±0.06)mm(t=4.726,P=0.001),提示撕囊更居中;操作用时由(138.12±34.92)s缩短为(84.15±27.34)s(t=3.813,P=0.004),提示操作更熟练;考核总分由(44.10±31.08)分提高为(95.30±4.40)分(t=-5.523,P=0.000)。专家评分显示:撕囊起始操作的成绩由培训前(3.70±0.59)分提高至培训后(4.44±0.31)分(t=-3.922,P=0.004);撕囊口形状的评分由(3.74±0.71)提高为(4.14±0.30)分,但差异无统计学意义(t=-1.519,P=0.163)。学员自我评价除在撕囊起瓣和撕囊形状操作上有明显进步外,其他手术技巧和步骤,如:人工晶状体植入、器械稳定性、减少组织牵拉、保护后囊以及手术速度均有明显提高(P均<0.05)。结论EyeSi系统可有效培训以撕囊为代表的白内障显微手术操作步骤。(眼科,2022,31:390-393)Objective To evaluate the application effect of EyeSi cataract phacoemulsification training system(EyeSi system)in cataract surgery training for ophthalmologists.Design Self-controlled study.Participants Ten Ophthalmologists under specialist training in Peking University Third hospital.Methods Using EyeSi system for cataract surgery training and the evaluation of capsulorhexis steps were recorded.Five cataract surgeons with senior professional titles scoring the trainees’operation videos before and after the training according to the blind method of the International Council of Ophthalmology Ophthalmology Surgical Competency Assessment Rubric(ICO-OSCAR).The trainees filled in the self-evaluation scale.Main Outcome Measures Assessment results of the EyeSi system,the ratings from the cataract specialists and the trainees'self-evaluation scale.Results EyeSi system showed that after training the uniformity of capsulorhexis radius was improved from(24.51±30.58)%to(95.90±7.00)%(t=-7.600,P=0.000),suggesting that the capsulorhexis was more round.The distance from the center of the capsulorhexis decreased from(0.38±0.14)mm to(0.11±0.06)mm(t=4.726,P=0.001),suggesting that the capsulorhexis was more centered.The operation time was shortened from(138.12±34.92)s to(84.15±27.34)s(t=3.813,P=0.004),indicating that the operation was more skilled.The total score increased from(44.10±31.08)to(95.30±4.40)(t=-5.523,P=0.000).The ICO-OSCAR showed that the performance of capsulorhexis was improved from(3.70±0.59)before training to(4.44±0.31)after training(t=-3.922,P=0.004).The score of capsulorhexis opening shape was improved from(3.74±0.71)to(4.14±0.30),but the difference was not statistically significant(t=-1.519,P=0.163).In addition to the obvious progress in the operation of capsulorhexis flap and capsulorhexis shape,the students'self-evaluation scale showed other surgical skills such as intraocular lens implantation,instrument stability,reducing tissue traction,protecting posterior capsule and operation speed,were als

关 键 词：白内障 手术培训 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]