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微创直接冠状动脉旁路移植术的模拟训练。

Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting.

机构信息

Cardiac Surgery Department, Peking University Third Hospital, Beijing, P.R. China.

出版信息

Heart Surg Forum. 2020 Oct 16;23(6):E774-E780. doi: 10.1532/hsf.3185.

Abstract

BACKGROUND

To evaluate the effect of minimally invasive direct coronary artery bypass (MIDCAB) simulator for cardiac residency training.

METHODS

A total of 26 resident surgeons who had never trained for coronary artery anastomosis participated in this training program. They received coronary artery anastomosis training on off-pump coronary artery bypass grafting (OPCAB) simulator for 15 h. After training, their performance of anastomosis was evaluated on the OPCAB simulator according to 12 items and a 5-point global rating scale. Based on the total score of assessment, those with an individual score of 12-36 formed group A, while group B was composed of the remaining trainees. The two groups then received another 15 h coronary artery anastomosis training on the MIDCAB simulator, and the performance was assessed.

RESULTS

Trainees improved their performance of coronary artery anastomosis after training on the OPCAB simulator. Group A was composed of 7 trainees with an individual with a total score of 12-36 points and group B was composed of the remaining 19 trainees. After MIDCAB simulator training, significant differences were noted in the pre- and post-training values in the A group (P < .001), and the assessment value of group A was significantly better than those of group B (P < .05). No significant difference was detected between pre- and post-training values in group B after MIDCAB simulator training (P > .05).

CONCLUSION

We concluded that trainees who performed well in OPCAB simulation training can also perform better in MIDCAB, and our designed MIDCAB simulator was useful for residency training.

摘要

背景

评估微创直接冠状动脉旁路移植术(MIDCAB)模拟器在心脏住院医师培训中的效果。

方法

共有 26 名从未接受过冠状动脉吻合术培训的住院医师参与了该培训计划。他们在非体外循环冠状动脉旁路移植术(OPCAB)模拟器上接受了 15 小时的冠状动脉吻合术培训。培训后,根据 12 项和 5 分制的整体评分标准,在 OPCAB 模拟器上评估他们的吻合术表现。根据评估的总分,个体得分在 12-36 分的入组 A,其余的入组 B。然后,两组人员在 MIDCAB 模拟器上再接受 15 小时的冠状动脉吻合术培训,并对其表现进行评估。

结果

住院医师在 OPCAB 模拟器上接受培训后,其冠状动脉吻合术的表现得到了提高。组 A 由 7 名个体总分在 12-36 分的住院医师组成,组 B 由其余 19 名住院医师组成。在 MIDCAB 模拟器培训后,A 组的培训前后评估值存在显著差异(P<0.001),且 A 组的评估值明显优于 B 组(P<0.05)。B 组在 MIDCAB 模拟器培训后,其培训前后评估值无显著差异(P>0.05)。

结论

我们得出结论,在 OPCAB 模拟培训中表现良好的住院医师也可以在 MIDCAB 中表现更好,并且我们设计的 MIDCAB 模拟器对住院医师培训是有用的。

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