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纤维支气管镜训练箱的研制及应用效果的初步评估
卞金俊△,王嘉锋△,万小健,朱科明*,邓小明
0
(第二军医大学长海医院麻醉科,上海 200433)
摘要:
目的研制一种简单实用的纤维支气管镜(简称纤支镜)训练器具,并初步评估其训练效果。方法本研究设计了一个用于训练纤支镜基础与高级技能的训练箱,训练箱内部设有5层隔板,隔板中根据人体各支气管开口相对位置设置有相应的小孔以便通过纤支镜。训练箱内可根据需要放置辅助物品以模拟异物等病变以供训练气管插管、活检、刷检、支气管肺泡灌洗等。为了评价训练效果,将40名从未做过纤支镜操作的志愿住院医师随机分成训练箱组(n=20)和对照组(n=20),分别经训练箱培训和传统视频教授后,在高级模拟人上开展纤支镜导引气管导管插管考核,比较两组插管时间。结果纤支镜能顺利通过训练箱中的所有小孔,镜下小孔排列位置与真实人体气管或支气管开口相似。所有受训住院医师均能完成纤支镜导引气管插管,但训练箱组住院医师完成插管时间为(55.7±10.2) s,显著少于对照组\[(69.3±8.9) s,P<0.001\]。结论该纤支镜训练箱简单实用,具有一定科学性,能用于纤支镜高级技能的训练,训练效果显著。
关键词:  支气管镜  医学训练  模拟器
DOI:10.3724/SP.J.1008.2010.080
投稿时间:2009-08-26修订日期:2009-09-15
基金项目:第二军医大学长海医院教学改革基金.
Preparation of a fiberoptic bronchoscopy training box and evaluation of its efficacy
BIAN Jin-jun△,WANG Jia-feng△,WAN Xiao-jian,ZHU Ke-ming*,DENG Xiao-ming
(Department of Anesthesiology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China)
Abstract:
Objective:To prepare a simple,practical fiberoptic bronchoscope (FB) training simulator,and to evaluate its training efficacy.Methods: A box apparatus was designed for basic and advanced FB training; the box consisted of five boards with holes in it.The holes were aligned according to the entries of bronchus to pass the FB.Assistant materials could be placed in the box to simulate foreign bodies due to diseases,which was aimed to help the training of sophisticated skills including tracheal tube intubation,biopsy,brushing and bronchoalveolar lavage.To testify the training efficacy,forty volunteer residents who had never manipulated a FB were randomly assigned into two groups:one group was trained using the prepared training box (Group TB,n=20) and the other group was trained using video-based technique (Group C,n=20).The trainees of the two groups received an intubation examination using an advanced patient simulator, and the periods of intubation was compared between the two groups.Results: Flexible fiberoptic bronchoscope could smoothly pass through the holes in the box; the photos of the holes under bronchoscopy well simulated the normal images.All residents completed the training and examination.The mean duration of intubation was (55.7±10.2) s in Group TB and (69.3±8.9) s in Group C (P<0.001).Conclusion: The present training box is simple and practical,and it can be used for advanced training of FB,with obvious training efficacy.
Key words:  bronchoscope  medical training  simulator