髋关节置换手术的仿真设计与虚拟医药教育模式

Simulation design and virtual medical education model of hip replacement surgery

目的虚拟设计关节置换外科手术模型、搭建以练代教的仿真平台,以此纠正外科教学的“学缺实操”局面。方法随机选取2016年7~8月在广州医科大学附属第一医院留医、患髋关节骨性关节炎拟行全髋关节置换术的患者1例,以CT扫描腰骶椎后,以*.dicom格式导入Mimics重建出骨盆三维模型,以*.stl格式导入Freeform Modeling,以计算机辅助设计软件ProE和Ghost SDK开发出仿真手术器械,在操纵杆Phantom引导下可视化演练全髋关节置换术。结果以3D轮动切割为观察指标,实验显示清晰重建出髋关节三维模型,虚拟设计的术械与实体器械几何外形酷似,全髋手术模型与实体手术高度仿真。结论这种“以练代教”为主体的培养模式,提供亲临其境的实操体验,效果显著,既可为医药课程提供教学案例又可为实体外科手术提供规划依据。

Objective Virtual design of joint replacement surgery model, to build a simulation platform to practice instead of teaching, on the occasion of surgical teaching to correct the "lack of practice" situation. Methods One patient who was admitted to the First Affiliated Hospital of Guangzhou Medical University from July to August 2016 and who suffered from hip osteoarthritis and planned to undergo total hip arthroplasty was randomly selected. After the lumbosacral vertebra was scanned by CT, the Mimics was imported into *.dicom format to reconstruct the 3D model of the pelvis, and Freeform Modeling was imported into *.stl format, the simulation surgical instrument was developed with the computer-aided design software ProE and Ghost SDK, and the visualized total hip replacement under the guidance of Phantom joystick was practiced. Results The experimental results showed that the 3D model of hip joint was clearly reconstructed by taking 3D wheeled cutting as the observation index. The geometrical shapes of the virtual designed surgical instruments and physical instruments were similar, and the total hip surgery model and physical surgery were highly simulated. Conclusion This training mode, with "training instead of teaching" as the main body, provides hands-on experience in the field, with remarkable effects. It can not only provide teaching cases for medical courses, but also provide planning basis for physical surgery.