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使用灌注人体尸体模型进行中心静脉置管:在外科手术教育中的应用。

Central venous catheterization using a perfused human cadaveric model: application to surgical education.

作者信息

Varga Stephen, Smith Jennifer, Minneti Michael, Carey Joseph, Zakaluzny Scott, Noguchi Thomas, Demetriades Demetrios, Talving Peep

机构信息

Trauma and Acute Care Surgery, Surgical Critical Care, Department of Surgery, San Antonio Military Medical Center, San Antonio, Texas.

Los Angeles County and University of Southern California Medical Center Fresh Tissue Dissection Laboratory, Los Angeles, California.

出版信息

J Surg Educ. 2015 Jan-Feb;72(1):28-32. doi: 10.1016/j.jsurg.2014.07.005. Epub 2014 Aug 14.

Abstract

OBJECTIVE

The purpose of this article is to present a unique training model using a perfused human cadaver for central line placement training with the ultimate goal of reducing central venous catheter mechanical complications.

DESIGN

The applicability of the fresh tissue cadaver model for central line placement was assessed using a 10-item questionnaire with a 5-point Likert-type scale. Respondents were asked to rate their opinions as strongly agree, agree, neutral, disagree, or strongly disagree.

SETTING

All participants received a didactic lecture followed by supervised practice on a commercially available simulator. The students were then relocated to the Fresh Tissue Dissection Laboratory where they practiced central vein catheterization on a fresh perfused human cadaver.

PARTICIPANTS

Course participants included 87 physicians from various medical specialties at different stages of training.

RESULTS

Results of the survey demonstrated that 91% of the participating physicians found the perfused cadaveric model to be a true simulation of conditions that exist in live patients, and 98% reported that the use of this model promoted acquisition of technical skills.

CONCLUSION

The integration of central line placement training on perfused cadavers into residency and fellowship training provides an unparalleled realistic simulation to participants. Further study is needed to assess whether realistic simulation translates into objective end points such as decreased mechanical complications.

摘要

目的

本文旨在介绍一种独特的培训模式,即使用灌注人体尸体进行中心静脉置管培训,最终目标是减少中心静脉导管机械性并发症。

设计

采用一份包含10个项目、5级李克特量表的问卷,评估新鲜组织尸体模型用于中心静脉置管的适用性。要求受访者将他们的意见评为强烈同意、同意、中立、不同意或强烈不同意。

背景

所有参与者先接受一次理论讲座,随后在商用模拟器上进行监督练习。然后,学生们转移到新鲜组织解剖实验室,在新鲜灌注的人体尸体上练习中心静脉导管插入术。

参与者

课程参与者包括来自不同医学专业、处于不同培训阶段的87名医生。

结果

调查结果显示,91%的参与医生认为灌注尸体模型真实模拟了活体患者的情况,98%的医生报告称使用该模型有助于技术技能的掌握。

结论

将灌注尸体的中心静脉置管培训纳入住院医师和专科医师培训,为参与者提供了无与伦比的真实模拟。需要进一步研究以评估这种真实模拟是否能转化为诸如减少机械性并发症等客观终点。

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