活体猪模型在高阶内镜治疗技术培训中的应用价值  

Application value of an in-vivo porcine model in the training of advanced endoscopic therapy

作　　者：王楠钧 柴宁莉[1] 令狐恩强[1] 李惠凯[1] 冯秀雪[1] 翟亚奇[1] 刘圣圳 张文刚 李隆松 王沙沙[1] 王祥耀 徐宁 高飞[1,3] Nanjun Wang;Ningli Chai;Enqiang Linghu;Huikai Li;Xiuxue Feng;Yaqi Zhai;Shengzhen Liu;Wengang Zhang;Longsong Li;Shasha Wang;Xiangyao Wang;Ning Xu;Fei Gao(Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,100853,Beijing,China;No.984 Hospital of PLA,100094,Beijing,China;Unit 73123,PLA Ground Force,350303,Fujian,China)

机构地区：[1]解放军总医院第一医学中心消化内科医学部,北京100853 [2]联勤保障部队第九八四医院,北京100094 [3]解放军73123部队,福建350303

出　　处：《中华胃肠内镜电子杂志》2022年第3期156-161,共6页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：国家重点研发计划(2016YFC1303601)。

摘　　要：目的通过活体猪模型实验,进一步证实和明确其在高阶内镜治疗技术培训中的应用价值。方法选取6名受训者接受活体猪模型培训,之后6名受训者与6名对照者均进行手把手教学培训。随后,对于受训者接受活体猪模型和手把手培训的差异性,以及受训者和对照者关于是否接受活体猪模型培训的差异性分别进行对比。结果所有活体猪模型和手把手培训手术均未出现术中大出血及术后迟发性出血,两种培训手术术中各有2例局部微小穿孔,以组织夹可有效封闭,均无术后迟发性穿孔;所有实验动物及患者未出现其他严重并发症。所有手术均完整剥离了病变,仅少数需上级带教医师接手后完成。接受活体猪模型培训后,受训者自身的剥离时间和剥离速度明显改善(P<0.05);相比于对照者,受训者的手术时间(包括各步骤时间)、剥离速度以及手术完成度评分、注射评分、切开评分均明显改善(P<0.05)。结论活体猪模型用于高阶内镜治疗技术的培训是安全有效的,其对于改善初学者的学习曲线及有效应对并发症均有所帮助。Objective To further confirm and clarify its application value in the training of advanced endoscopic therapy through an in-vivo porcine model.Methods 6 trainees were selected to receive in-vivo porcine model training,and then 6 trainees and 6 controls were given hand-to-hand training.Then,the differences between trainees receiving live pig model and hand-held training,as well as the differences between trainees and controls regarding whether to receive live pig model training were compared.Results There was no intraoperative hemorrhage and delayed postoperative hemorrhage in all the in-vivo porcine models and hand-to-hand training operations.There were 2 cases of local minor perforation in each training operation,which could be effectively closed by tissue clip,and no delayed postoperative perforation.No other serious complications occurred in all experimental animals and patients.All the operations were completely dissection of the lesions,only a few of them needed to be completed by superior teaching physicians.After receiving in-vivo porcine model training,the dissection time and speed of the trainees were significantly improved(P<0.05).Compared with the control group,the operation time(including the time of each step),dissection speed,operation completion score,injection score and incision score of the trainees were significantly improved(P<0.05).Conclusion The in-vivo porcine model is safe and effective for the training of advanced endoscopic therapies.It is helpful to improve the learning curve of beginners and effectively deal with complications.

关 键 词：活体猪模型 高阶内镜治疗技术 学习曲线 安全性 

分 类 号：R-4[医药卫生] G642[文化科学—高等教育学]