医学教育管理 ›› 2016, Vol. 2 ›› Issue (5): 693-702.doi: 10.3969/j.issn.2096-045X.2016.05.014

• 临床教学 • 上一篇    下一篇

离体动物模型在消化专业研究生内镜治疗技术培训中的应用价值

孔 阳,朱圣韬,冀 明,张澍田,李 鹏   

  1. 首都医科大学附属北京友谊医院消化内科、国家消化系统疾病临床医学研究中心、北京市消化疾病中心、首都医科大学消化病学系,北京 100050
  • 收稿日期:2016-06-22 出版日期:2016-10-20
  • 基金资助:
    1.国家自然基金(81101842、81272447、81570507、81302160);2.首都卫生发展科研专项项目(首发 2014-1-2021 );3.北京市医院管理局临床医学发展专项(ZY201308);4.首都临床特色应用研究(Z121107001012001)

Value of vitro animal model for endoscopic training for postgraduates of digestion

Kong Yang, Zhu Shengtao, Ji Ming, ZhangShutian, Li Peng   

  1. Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; National Clinical Research Center for Digestive Diseases; Beijing Digestive Disease Center; Faculty of Gastroenterology, Capital Medical University, Beijing 100050, China
  • Received:2016-06-22 Online:2016-10-20

摘要: 目的 探索离体动物模型在消化专业研究生内镜治疗技术的应用价值。方法 对我院消化科研究生13人,先进行理论知识学习,完成调查问卷,对基本资料进行基线比较。随后,将其随机分临床观察学习组(A组)和离体动物模型组(B组)。A组与B组在临床观察学习内镜下息肉切除术、内镜下黏膜切除术、内镜下黏膜剥离术6个月,B组在临床观察学习期间进行12次时长约6小时的离体动物模型培训课程。培训结束后进行考核,对操作得分、操作时间、有无并发症等分别进行统计学分析,并再次完成调查问卷。结果 A组临床观察学习组与B组离体动物模型组在内镜下息肉切除术总操作时间、总得分及自信心程度无明显差异(P>0.05)。B组EMR所用时间明显少于A组(P<0.05)。B组EMR操作的自信心程度(3.4±0.5)较A组(2.3±0.5)有所提高(P<0.05)。B组离体动物模型组和A组临床观察学习组ESD的总操作时间分别为(48.9±19.0)min、(88.8±27.8)min,B组ESD所用时间明显少于A组(P<0.05),在标记时间、切开时间及黏膜剥离时间方面也有显著差异(P<0.05),而注射时间无差异。B组ESD自信心程度(2.9±0.7)较A组(1.5±0.5)有所提高,差异具有统计学意义(P<0.05)。两组在三种技术操作过程中均未发生穿孔。离体动物模型组研究生在培训课程培训后,在内镜治疗技术原理及器械的了解程度、自信心程度方面有明显提高。结论 以理论知识为基础结合离体动物模型实践操作的内镜教学方法,能够使消化研究生熟悉并初步掌握内镜治疗技术的基础理论知识以及操作方法,对日后内镜技术在临床开展的自信心有较大的提高。

Abstract: Objective To explore the value of vitro animal model for endoscopic training for the postgraduates of digestion. Methods 13 postgraduates learned the theory of endoscopic skills and completed a questionnaire firstly. Then they were randomized to receive endoscopic training either on the vitro animal (group B) or on training experience (group A) for 6 months of the clinical observation. At last, one case was assessed by a blinded expert. The total scores, operating time and complications were recorded. All postgraduates completed the questionnaire once again. Results There were no difference between the two groups in total time, total scores and confidence of endoscopic polypectomy. For EMR, group B spent significantly less time than group A (P<0.05) and had more confidence. For ESD, the total time of group B and group A are (48.9±19.0)min and (88.8±27.8)min respectively. Complications were recorded. There were significant differences between the two groups, especially on marking time, cutting time and dissection time (P<0.05), but there were no difference on injection time. The confidence level of group B (2.9±0.7) was significantly higher than that of group A (1.5±0.5) (P<0.05). There was no perforation in the two groups. For group B, their knowledge of technical and equipment principle of endoscopy and their confidence had been obviously increased after the endoscopic training on vitro animal model. Conclusion Theory combined with endoscopic training on vitro animal model can make the postgraduates familiar with and master the basic theory and endoscopic skills.