3D打印在经皮肾镜手术教学培训中的应用探索
摘要
目的探究3D打印在经皮肾镜手术教学培训中的应用效果。方法选择8例经影像学确诊为肾结石的患者CT资料,使用计算机辅助设计并经3D打印机用不同颜色树脂材料打印出实物肾脏模型。对比两组未实际操作经皮肾镜手术医师(每组各4人),经传统模具法培训学习经皮肾镜与3D打印法培训学习经皮肾镜6个月后,完成同等数量(12例)的经皮肾镜手术穿刺建立通道时间、清石率、出血量。结果 6个月后,与经传统模具法培训学习的医师相比,经3D打印法培训的医师手术穿刺所需针数更少,建立通道时间更快速,出血量更少,清石率更高,其中在通道建立耗时、出血量及清石率方面,组间比较差异有统计学意义(P<0.05)。结论采用3D打印法制作的肾脏模型培训可以在经皮肾镜手术学习曲线初期强化医师的通道设立理念,取得更快速、安全的培训效果。
引文
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[2]Yang YH,Wen YC,Chen KC,et al.Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy:a systematic review and meta-analysis[J].World J Urol,2018,9(22):1-12.
[3]Chen YC,Chen HW,Juan YS,et al.Management of Large Proximal Ureteral Calculi:A Three-year Multicenter Experience of Simultaneous Supine Percutaneous Nephrolithotomy and Retrograde Ureterolithotripsy[J].Urol J,2018,9(11):63.
[4]唐润,刘林.用于经皮肾镜取石术模拟的肾脏3D打印模型研究初探[J].中华泌尿外科,2015,36(12):886-890.
[5]Clavica F,Zhao X,ElMahdy M,et al.Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model[J].PLoS One,2014,9(2):1-11.
[6]Ghazi A,Campbell T,Melnyk R,et al.Validation of a Full-Immersion Simulation Platform for Percutaneous Nephrolithotomy Using Three-Dimensional Printing Technology[J].J Endourol,2017,31(12):1314-1320.
[7]Favorito LA.Kidney anatomy:three dimensional(3D)printed pelvicalyceal system models of the collector system improve the diagnosis and treatment of stone disease[J].Int Braz J Urol,2017,43(3):381-382.
[8]时佳子,王杰,王志向,等.3D打印在泌尿外科个体化治疗中的应用[J].实用医学杂志,2015,31(23):3957-3959.
[9]魏晓松,刘征,庄乾元,等.3D打印技术在经皮肾镜取石术术前规划及医患沟通中的应用研究[J].中华泌尿外科杂志,2015,26(12):881-885.
[10]Del Junco M,Yoon R,Okhunov Z,et al.Comparison of Flow Characteristics of Novel Three-Dimensional Printed Ureteral Stents Versus Standard Ureteral Stents in a Porcine Model[J].J Endourol,2015,29(9):1065-1069.