仿真与凝胶模型对超声引导下腹横肌平面阻滞教学的影响

Impact of simulation model and gel model for the training of ultrasound-guided transversus abdominis plane block

目的 探讨仿真与凝胶模型对超声引导下腹横肌平面神经阻滞教学的影响。方法 选择未进行过超声引导下区域阻滞的医师,随机分为2组,凝胶组(n=36)和仿真组(n=36)。凝胶组采用凝胶模型,仿真组采用猪肉制作的仿真模型进行练习。对所有学员进行培训前后自我认知、自信心和焦虑评估。培训后进行操作考核,并进行满意度调查。结果 两组性别、年龄及职称差异无统计学意义(P> 0.05)。通过培训提高了学员对腹横肌平面(transversus abdominis plane,TAP)操作的相关解剖掌握程度及平面内进针技术,提高了自信并降低了焦虑(P<0.05)。仿真模型提供了更真实的穿刺突破感,且学员在培训后的考核成绩20.5(18.0,22.0)分高于凝胶组19.0(16.0,21.0)分(P<0.05)、TAP操作时间10.0(8.0,12.0)分钟短于凝胶组组12.0(12.0,15.0)分钟(P<0.05)。结论 超声引导下TAP阻滞培训课程可提高学员对这项技能的掌握程度,提高学员的自信并降低焦虑,为其在临床上进行该操作做好准备。仿真模型的应用进一步提高了考核成绩,学员满意度更高。

Objective To explore the effect of simulation model and gel model on the training of ultrasound-guided transversus abdominis plane(TAP)block.Methods Anesthesiologists who had not performed regional block under ultrasound guidance were randomly divided into 2 groups:gel group(n=36)and simulation group(n=36).During skill training,the gel group adopted the gel model,and the simulation group adopted the simulation model made of pork for practice.Self-cognition,self-confidence and anxiety were evaluated before and after training.After training,the operation assessment was carried out and the satisfaction survey was conducted.Results There was no statistically significant difference in gender,age,and professional title between the two groups(P>0.05)Through the training,the theoretical knowledge of TAP and technique of in-plane needle insertion were improved,anxiety was decreased and confidence was improved(P<0.05).The simulation model provided a more realistic puncture breakthrough feeling than the gel model(P<0.05).What's more,the examination score 20.5(18.0,22.0)was higher than that of gel group 19.0(16.0,21.0)(P<0.05),and operation time 10.0(8.0,12.0)min was shorter than that of gel group 12.0(12.0,15.0)min(P<0.05).Conclusion The training course of ultrasoundguided TAP block can improve the mastery of TAP nerve block skill,enhance the confidence and reduce the anxiety.The application of the simulation model may further improve the assessment results,and obtain higher satisfaction of the trainees.