颈动脉插管模型在介入教学培训中的应用价值研究

Application value of carotid artery cannulation model in teaching and training

目的:构建颈动脉和脑血管介入教学模拟系统,以此培训介入医师相关操作技术,并评估此系统在教学过程中的应用价值。方法:将40位测试者分成新手组和经验组,使用H1血管造影导管进行颈动脉插管的操作。测试者依据标准进行操作,分别记录首次操作以及训练30~60 min后的末次操作的完整操作时间,进行统计学分析。另外,操作者填写一份调查问卷,对模拟操作系统实际训练效果进行评估。结果:40位测试者(20位新手者,20位经验者)完成本实验。新手组末次操作总用时(55.32±4.99)s,较首次操作的(90.32±9.85)s提高38.8%(P<0.01);经验组末次操作总用时(31.14±3.78)s,较首次操作的(36.18±4.16)s提高13.9%(P<0.01)。2组测试者经练习后颈动脉插管总用时均有不同程度的减少,且新手组用时减少程度比较明显(30%~40%,P<0.01)。新手组在操作"导管头置于无名动脉"、"导管头置于C2水平"以及整体的训练前后时间减少最明显(A时间点减少40.1%,C时间点减少39.6%,总用时减少38.8%)。分析调查问卷可知:新手组与经验组均认为颈动脉模型与人体血管较相似,且本系统在模拟临床操作和实时成像过程较真实,有助于提高操作技能,并认为操作者接受此模型的训练会对临床实际操作有帮助(总体评分3.5分)。结论:颈动脉插管教学模型对于培训介入医师、提高初学者操作水平有肯定的促进作用。

Objective： To establish a teaching simulation system of carotid artery cannulation in order to train the interventional physicians mastering the related operation technology and to evaluate its value in clinical teaching and training practice. Methods： Forty participants were divided into two groups： the novice group and experienced group, and the cannulation of cerebral vascular catheterization was performed using H1 angiography catheter. The participants practiced according to the standard, and the operation time at the beginning, and 30-60 rain after training was recorded and analyzed statistically. In addition, the participants filled out a questionnaire for evaluating the clinical condition of the operating system, real-time imaging and testing technology. Results： Forty participants （20 novice, 20 experienced） participated fully in the study. Participants in the novice group significantly improve their total completion time （38.8% , P〈0.01 ） from preliminary test [（90.32±9.85） s] to terninal test [（55.32±4.99） s], compared with the experienced group（13.9%, 36.18±4.16, 31.14±3.78）. The total time was reduced in a marked degree （30%-40% , P〈0.01 ）. The novice group had the most significant differenee before and after training when they did the two steps of ＂catheter placed in the innominate artery＂ and ＂catheter placed in the C2 level＂. The overall proeedure time was obviously decreased. （A time reduced by 40.1%, C time reduced by 39.6%, with a total reduction of 38.8% ）. Questionnaire survey results showed that both of novice and experienced groups considered that the model of cerebral vessels was quite similar to human vessels, and the simulation system was real and helpful to improve the skills of the trainees in the clinical operation and real-time imaging process, and they thought the model training would be helpful for clinical practice（the score was 3.5）.Conclusions： Carotid artery cannulation teaching model tor the training of interventional physicians could improve the level of beginners and have a positive promoting effect.