神经内镜高血压脑出血手术3D打印训练模型及培训方法

Design and development of a three-dimensional printed training model for neuroendoscopic evacuation surgery for hypertensive intracerebral hemorrhage

目的 设计一款用于神经内镜下高血压脑出血手术血肿清除以及渗血止血操作训练的3D打印模型。方法 模型分为颅骨部、血肿部以及渗血部。使用猪血模拟血肿,用琼脂溶液模拟脑组织。学员在内镜下清除血肿,并进行渗血止血操作训练。记录下学员清除血肿的重量以及止血操作所用时间来计算训练得分。结果 共有32位学员完成清除血肿操作,15位学员完成止血操作。有内镜经验组相比于无内镜经验组,其清除血肿重量、止血操作所用时间和总得分均表现更好(P<0.05)。使用该模型进行训练和通过传统方式学习(手术视频讲解)的住培学员调查问卷结果显示,该模型在教学上的价值高于传统学习方式。结论 研发了首款可同时用于练习血肿清除以及渗血止血操作技术的3D打印模型。

Objective To design and develop a three-dimensional printed training model for practicing the skills of hematoma evacuation and hemostasis of oozing bleeding in neuroendoscopic evacuation surgery for hypertensive intracerebral hemorrhage.Methods The model was divided into skull part,hematoma part,and oozing bleeding part.Pig blood was used to simulate hematoma,and agar solution was used to simulate brain tissue.Trainees needed to evacuate the hematoma under an endoscope and practice the hemostasis of oozing bleeding.The weight of the hematoma evacuated and the time needed for hemostasis were recorded for each trainee to calculate the training score.Results A total of 32 trainees completed hematoma evacuation and 15 trainees completed hemostasis.Compared with the group without experience in endoscopy,the group with experience in endoscopy had better performance in the weight of the hematoma evacuated,the time needed for hemostasis,and total score(P<0.05).A questionnaire survey was performed among the resident trainees who used this model or conventional learning method(explanation of surgery videos),and the results showed that this model had a better teaching value than the conventional learning method.Conclusion This study develops the first three-dimensional printed model for practicing the basic skills of hematoma evacuation and hemostasis of oozing bleeding at the same time.