腹腔镜仿真子宫模型在妇科住院医师培训中的应用

Application of laparoscopic simulated uterine model in gynecological resident training

目的对比多角度缝合腹腔镜仿真子宫模型和传统外科手术模型的训练效果,探索出更适用于妇科住院医师培训的腔镜模型。方法选择2021年2月至2023年2月在浙江大学医学院附属邵逸夫医院培训的住院医师48名,分批训练,每批随机平均分为两组,观察组运用传统外科手术模型和普通手术视频进行训练,试验组运用本研究组成员自主研发、可多角度缝合的腹腔镜仿真子宫模型和配套手术视频进行训练。最后对比两组住院医师考核成绩以及对试验组进行问卷调查。采用SPSS 20.0统计软件对结果进行t检验或卡方检验。结果两组住院医师在年龄、性别分布、学历、临床经验方面差异无统计学意义。试验组[(82.63±3.93)分]和观察组[(85.00±6.15)分]理论成绩差异无统计学意义(P>0.05)。在技能考核上,两组前壁考核差异无统计学意义[(83.08±4.47)分vs.(82.79±3.58)分,P=0.804]。但在侧壁和后壁考核时,试验组熟练度、精确度和双手协调程度均优于观察组,总分差异有统计学意义[(64.13±3.34)分vs.(46.75±3.50)分,(62.25±4.41)分vs.(45.00±2.89)分,P<0.001]。在调查问卷中,试验组对腹腔镜仿真子宫模型的满意度高,认为模型仿真度高,可从中受益。结论多角度缝合的腹腔镜仿真子宫模型相较于传统外科模型,能高质量地提高住院医师操作水平,为今后妇科住培腹腔镜模型训练提供了新思路。

Objective To compare the training effect between the laparoscopic simulated uterine model(LSUM)with multi-angle suture and the traditional surgical model and to identify a laparoscopic model more suitable for gynecological resident training.Methods Forty-eight residents who were trained in Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from February 2021 to February 2023 were selected.They were trained in batches,with each batch randomly divided into two groups of the same size.The observation group was trained with the traditional surgical model and general surgical videos,while the experimental group was trained with a self-developed LSUM with multi-angle suture and corresponding surgical videos.Finally,the two groups were compared for the assessment results,and a questionnaire survey was conducted in the experimental group.The statistical software SPSS 20.0 was used for t-test or chi-square test of the results.Results There were no significant differences between the two groups in age,gender distribution,education level,and clinical experience.In theoretical assessment results,no significant difference was shown between the experimental group and the observation group[(82.63±3.93)vs.(85.00±6.15),P>0.05].In skill assessment results,there was no significant difference between the two groups in the anterior wall assessment[(83.08±4.47)vs.(82.79±3.58),P=0.804].However,in the assessment of the lateral and posterior walls,the proficiency,accuracy,and degree of coordination between two hands of the experimental group were better than those of the observation group,with the total score being significantly different[(64.13±3.34)vs.(46.75±3.50),(62.25±4.41)vs.(45.00±2.89),P<0.001].In the questionnaire survey,the experimental group had a high degree of satisfaction with the LSUM and thought that the highly simulated model was beneficial to their training.Conclusions Compared with the traditional surgical model,the LSUM with multi-angle suture can effectively improve the operation level of residents,which provides a new idea for the laparoscopic simulation training of gynecological residents in the future.