椎弓根置钉模拟训练在男性住院医师技能训练中的应用

Application of Simulation Training for Lumbar Pedicle Screw Fixation in Male Residents

目的比较模拟训练和传统训练方法在男性脊柱外科住院医师腰椎椎弓根螺钉置钉单项技能训练中的效果。方法选取2017年1月1日—2018年4月1日在某教学医院脊柱外科轮转的60名男性住院医师作为研究对象。将其随机分为传统组和模拟组,分别进行腰椎椎弓根螺钉置钉训练,训练后每人独立完成1例腰椎手术的椎弓根螺钉置钉操。比较两组操作成功率、操作时长、试操作次数和并发症发生率等。结果完成学员中,模拟组置钉成功率为80.00%,传统组置钉成功率为53.33%。模拟组置钉成功率较传统组明显提高,差异具有统计学意义(P<0.05)。模拟组总操作时长(8.57±1.40)min,传统组(10.40±1.49)min,模拟组试操作数(1.50±0.82)次,传统组(2.30±0.84)次,模拟组并发症发生率12.50%,传统组43.75%。与传统组相比,模拟组操作成功率显著增加,差异具有统计学意义(P<0.05),操作时长显著缩短,差异具有统计学意义(P<0.05),操作次数显著减少,差异具有统计学意义(P<0.05),并发症发生率显著降低,差异具有统计学意义(P<0.05)。结论模拟训练与传统训练相比,提高了男性脊柱外科住院医师腰椎椎弓根螺钉置钉的成功率,缩短了操作时长,降低了并发症发生率。

Objective To compare the result of simulation training with traditional training for lumbar pedicle screw fixation.Methods 60 male resident rotated in department of spine surgery at a single teaching hospital from January 1,2017 to April 1,2018 were selected as the study objects and they were randomly assigned into two groups,simulation group(SG)and traditional group(TG).After the training,they must complete one lumbar pedicle screw fixation.The success rate,operation time,attempt times,and complication rates between the two groups were compared.Results The successful rate of the simulation group was 80.00%,while the success rate of the traditional group was 53.33%.The success rate of nail placement in the simulation group was significantly higher than that in the traditional group(P<0.05).The total operation time of the simulation group was(8.57±1.40)min,and the traditional group(10.40±1.49)min.The number of simulated group operations was(1.50±0.82)times,the traditional group(2.30±0.84)times.The incidence of complications was 12.50%in the simulated group and 43.75%in the traditional group.Compared with the traditional group,the success rate of operation in the simulation group was significantly increased,the difference was statistically significant(P<0.05).The duration of operation was significantly shortened,and the difference was statistically significant(P<0.05).The number of operations decreased significantly,the difference was statistically significant(P<0.05).The incidence of complications decreased significantly,the difference was statistically significant(P<0.05).Conclusion The simulation training significantly improved the success rate of lumbar pedicle screw fixation by shortening the length of procedure,decreasing the attempt times and lowering the complication rates.It deserved popularization in resident training in teaching hospitals.