基于薄层CT影像3D打印技术在胸外科规培教学中的应用

Application of 3D printing technology based on thin-layer CT images in the teaching of standardized training in the department of thoracic surgery

目的探索3D打印技术在胸外科肺癌根治术解剖教学中的应用效果。方法选取2018年9月至2020年9月在广州医科大学附属第一医院胸外科规培轮转的40名青年医生作为研究对象。以信封抽签的方式将其随机分为试验组和对照组,每组各20名。对照组进行传统教学培训,试验组进行3D打印技术辅助的培训。培训1个月后用客观教学效果测试考核与主观教学效果问卷调查来评价。采用SPSS 24.0进行t检验、卡方检验或Fisher精确概率检验。结果所有学员分别在平扫CT下与术中胸腔镜视野下,识别肺段动脉、肺段支气管、肺段静脉、第7组纵隔淋巴结、第2、4组淋巴结(右侧)或第5、6组淋巴结(左侧)共5组解剖结构。试验组学员的CT平扫识别准确性[(84.00±11.42)分]与胸腔镜解剖识别准确性[(74.00±13.14)分]均高于对照组[(71.00±10.71)(56.50±9.88)分]。试验组学员的主观评价在教学方式认可度、教学兴趣提高度、CT影像熟悉度、术中解剖熟悉度方面均高于对照组。结论相比传统教学,3D打印技术可提高学员的客观教学效果测试考核成绩,同时可提高学员的教学方式认可度、教学兴趣提高度、CT影像熟悉度及术中解剖熟悉度。

Objective To explore the application of 3D printing technology in anatomy teaching of radical resection of lung cancer in the department of thoracic surgery.Methods Forty young doctors who took turns in the routine training of thoracic surgery department of The First Affiliated Hospital of Guangzhou Medical University from September 2018 to September 2020 were selected as the research objects.They were randomly divided into the experimental group and the control group by envelope lottery,with 20 doctors in each group.They were respectively trained with traditional teaching and 3D printing technology.After one month of training,objective teaching content test and subjective teaching effect questionnaire were used to evaluate the effect.SPSS 24.0 was used for t-test,Chi-square test or Fisher exact probability test.Results Under plain CT scan and video-assisted thoracoscopy during operation,all the students identified five groups of anatomical structures:pulmonary artery,pulmonary bronchus,pulmonary vein,mediastinal lymph nodes in group 7,lymph nodes in groups 2 and 4(right)or lymph nodes in groups 5 and 6(left).The accuracy of CT and video-assisted thoracoscopy in the experimental group[(84.00±11.42)points and(74.00±13.14)points]were higher than those in the control group[(71.00±10.71)points and(56.50±9.88)points].The subjective evaluation of the students in the experimental group was higher than those in the control group in the recognition of teaching methods,the improvement of teaching interest,the familiarity with CT images and the familiarity with intraoperative anatomy.Conclusion Compared with the traditional teaching,3D printing technology can improve the students'scores of objective teaching content test,and can improve the students'recognition of teaching methods,teaching interest,CT image familiarity and intraoperative anatomy familiarity.