3D打印手术训练模型在机器人辅助腹腔镜泌尿外科手术术前访视中的应用研究  

Application of 3D printing surgical training models in the preoperative assessment of robot-assisted laparoscopic urologic surgery

作　　者：喻晓芬[1] 何茫茫 袁琳琳 YU Xiaofen;HE Mangmang;YUAN Linlin(Operating Room,Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院·杭州医学院附属人民医院手术室,浙江杭州310014

出　　处：《机器人外科学杂志(中英文)》2025年第3期421-426,共6页Chinese Journal of Robotic Surgery

基　　金：浙江省医药卫生科技计划项目(2024KY035)。

摘　　要：目的:探讨3D打印手术训练模型在机器人辅助腹腔镜泌尿外科手术术前访视中的应用效果。方法:选取2023年4月—2023年9月浙江省人民医院接受机器人辅助腹腔镜泌尿外科手术的150例患者,并按照收治的时间顺序分组。2023年4月—2023年6月收治的74例患者纳入对照组,2023年7月—2023年9月收治的76例患者纳入观察组。观察组采用3D打印手术训练模型联合口述及视频宣教术前访视模式,对照组采用口述及视频宣教术前访视模式。比较两组患者访视前、麻醉诱导前焦虑与信息需求评分,以及术前1 d 6:00(T0)、术日早上6:00(T1)、术后第1 d 6:00(T2)、术后第3 d 6:00(T3)不同时间点血清白细胞介素6(IL-6)、血管紧张素Ⅱ(AngⅡ)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)、平均动脉压(MAP)、心率(HR)各生理应激指标变化;比较两组患者访视前、麻醉诱导前手术认知度及术前准备完善率。结果:麻醉诱导前,观察组的焦虑和手术信息需求评分低于对照组,且观察组麻醉诱导前的评分低于访视前(P<0.001)。与术前时间点相比,两组患者术后各时间点的各指标呈下降趋势;与对照组比较,观察组在T1时间点的IL-6、AngⅡ、ACTH、Cor、MAP及HR各生理应激指标更低(P<0.05),在T0、T2、T3时间点各指标的数值相近(P>0.05);两组组内各生理应激指标总体分布存在统计学差异(P<0.001)。麻醉诱导前观察组手术认知度高于对照组,观察组术前准备完善率优于对照组(P<0.05)。结论:3D打印手术训练模型联合口述及视频宣教的术前访视模式能有效降低机器人辅助腹腔镜泌尿外科手术患者的心理应激反应和生理应激反应,提高患者手术认知度及术前准备完善率。Objective:To explore the application effect of 3D printing surgical training models in the preoperative assessment of robotassisted laparoscopic urologic surgery.Methods:150 patients who underwent robot-assisted laparoscopic urological surgery in Zhejiang Provincial People’s Hospital from April 2023 to September 2023 were selected,and 74 of them from April 2023 to June 2023 were assigned to the control group(oral and video health education),While 76 of them from July 2023 to September 2023 were assigned to the observation group(3D printed surgical training model combined with oral and video health education).The preoperative anxiety and information demand scores were compared between the two groups.The scores of anxiety and information demand before the visit and anesthesia induction,as well as the physiological stress indicators including interleukin 6(IL-6),angiotensinⅡ(AngⅡ),adrenocorticotropic hormone(ACTH),cortisol(Cor),average arterial pressure(MAP),and heart rate(HR)at 6 a.m.1 d before surgery(T0),day of surgery(T1),1 d after surgery(T2),and 3 d after surgry(T3)were compared between the two groups.The surgical awareness and perfection rate of preoperative preparation before the visit and induction of anesthesia were also compared between the groups.Results:Before the induction of anesthesia,the scores of anxiety and surgical information demand in the observation group were lower than those in the control group,and the above scores of the observation group before the induction of anesthesia were lower than those before the visit(P<0.001).Compared with that before surgery,indicators in the two groups showed a decreasing trend at postoperative timepoints.Compared with the control group,the physiological stress indicators of IL-6,AngⅡ,ACTH,Cor,MAP,and HR were lower in the observation group at the T1 timepoint(P<0.05),and the they were similar at the T0,T2,and T3 timepoints(P>0.05).The distribution of overall physiological stress indicators was statistically different in both groups(P<0.001).Before the

关 键 词：3D打印技术 机器人辅助腹腔镜手术 泌尿外科手术 术前访视 

分 类 号：R473[医药卫生—护理学]