3D胸腔镜手术联合三维肺血管支气管重建教学在胸外科临床实习中的应用

Evaluation of combined three-dimensional computed tomography bronchography and angiography with 3D video thoracoscopic surgery in the clinical practice of thoracic surgery

目的研究应用3D胸腔镜手术联合三维肺血管支气管重建教学在胸外科实习学生中的应用效果。方法选取在解放军总医院第七医学中心胸外科实习的五年制本科临床实习生60人,分为实验组(30人)与对照组(30人),授课内容为肺癌诊断和手术治疗。实验组采用三维肺血管支气管重建与3D胸腔镜技术相结合的方法进行教学,学生结合三维重建的肺血管支气管模型讲解肺解剖和诊断,参观3D胸腔镜下肺癌根治术;对照组采用普通胸腔镜肺癌手术。课程结束后统一进行理论和临床考核,并进行问卷调查。采用SPSS 18.0进行t检验和卡方检验。结果实验组的理论考核成绩与对照组相比差异无统计学意义;实验组临床考核成绩优于对照组,差异有统计学意义(P<0.05)。问卷调查显示,实验组教学方法在有利于激发学生学习兴趣、提高实习积极性、促进知识的理解方面优于对照组。结论3D胸腔镜手术联合三维肺血管支气管重建教学在胸外科临床实习中具有较好效果,值得进一步探索应用。

Objective To investigate the effects of 3D video thoracoscopic surgery combined with 3D CTBA(three-dimensional computed tomography bronchography and angiography)method in clinical education practice of the undergraduates.Methods The study included in 60 undergraduate clinical interns from our hospital,and they were randomly divided into the experimental group(n=30)and control group(n=30).The teaching content was diagnosis and surgical treatment of lung cancer.The experimental group applied 3D video thoracoscopic surgery combined with 3D CTBA teaching method.The interns studied the anatomy of lung and diagnosis of lung cancer based on the 3DCTBA and visited the operation of lung cancer under 3D thoracoscopy,which enhanced their knowledge of anatomical structure of lung.The control group applied traditional thoracoscopic surgery for lung cancer.Upon termination of clinic practice,all interns were tested with theoretical and clinical knowledge of lung cancer.A questionnaire survey was conducted among them to access the teaching effect.SPSS 18.0 was used for t test and chi-square test.Results The scores of theory test were not significantly different between two groups.The scores of anatomic and operational knowledge of lung in the experimental group were significantly higher compared with the control group(P<0.05).Questionnaire result showed that new teaching method could promote the interest in learning,motivated the desire for thoracic surgery,and improved the comprehension of clinical knowledge.More students approved the new teaching method.Conclusion The new method,3D video thoracoscopic surgery combined with 3D CTBA,has beneficial effect on clinical interns,which contributes to inspire the motivation and interest of learning and deepen clinic knowledge,and is a promising teaching method worthy of further exploration and application.