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冠状动脉造影模拟培训及其对导管室实际操作的影响。

The Simulation Training in Coronary Angiography and Its Impact on Real Life Conduct in the Catheterization Laboratory.

机构信息

Université de Lorraine, 54000, Nancy, France; Département de Cardiologie, Centre Hospitalier Universitaire Brabois, Nancy, France.

Université de Lorraine, 54000, Nancy, France; Département de Cardiologie, Centre Hospitalier Universitaire Brabois, Nancy, France.

出版信息

Am J Cardiol. 2019 Apr 15;123(8):1208-1213. doi: 10.1016/j.amjcard.2019.01.032. Epub 2019 Jan 24.

DOI:10.1016/j.amjcard.2019.01.032
PMID:30732853
Abstract

Our study aimed to evaluate the effectiveness of mentored simulation training (ST) in coronary angiography and to assess the transferability of acquired skills from virtual reality to the real world. Twenty cardiology residents were randomized to ST or control before performing real-life cases in the catheterization laboratory. The control group underwent secondary ST and reperformed real-life cases in the catheterization laboratory. Skill metrics were compared between the ST and the control group, and within the control group between before and after ST. In real-life cases, the procedure time was shorter (p = 0.002), the radiation dose lower (p = 0.001), and the global procedure skill score was higher (p = 0.0001) in the ST group as compared with the control (before ST) group. During virtual ST procedural time (p <0.001), fluoroscopic time (p <0.001), training contrast amount (p <0.001), and global training score (p <0.001) significantly decreased. In the control group, all monitoring procedure parameters were significantly improved after ST, as well as, the global procedure flow score (p <0.0001). In conclusion, simulator-based training in coronary angiography improved operator skills compared with traditional in catheterization laboratory mentor-based training. ST should be incorporated in the curriculum of the interventionalist to improve learning in coronary angiography.

摘要

我们的研究旨在评估有指导的模拟训练(ST)在冠状动脉造影中的有效性,并评估从虚拟现实到现实世界中获得的技能的可转移性。20 名心脏病学住院医师在导管实验室进行真实病例之前,随机分为 ST 组或对照组。对照组在导管实验室进行二次 ST 并重新进行真实病例。比较 ST 组和对照组之间以及对照组之间 ST 前后的技能指标。在真实病例中,与对照组(ST 前)相比,ST 组的手术时间更短(p=0.002),辐射剂量更低(p=0.001),整体手术技能评分更高(p=0.0001)。与 ST 前相比,在虚拟 ST 手术时间(p<0.001)、透视时间(p<0.001)、培训对比剂用量(p<0.001)和整体培训评分(p<0.001)显著降低。在对照组中,所有监测手术参数在 ST 后均显著改善,以及整体手术流程评分(p<0.0001)。总之,与传统的导管实验室基于导师的培训相比,基于模拟器的冠状动脉造影培训可提高操作人员的技能。ST 应纳入介入医师的课程中,以提高冠状动脉造影的学习效果。

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