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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。
Objective To develop a simple and practical fiberoptic bronchoscopy (bronchoscopy) training apparatus, and preliminary assessment of the training effect. Methods In this study, a training box was designed to train the basic and advanced skills of fiberoptic bronchoscopy. There were 5 baffles in the training box. The baffles were provided with corresponding holes according to the relative positions of the bronchial openings in the human body so as to pass the fiber branches mirror. Training boxes can be placed according to the needs of ancillary items to simulate foreign body lesions for tracheal intubation, biopsy, brush examination, bronchoalveolar lavage and so on. In order to evaluate the training effect, 40 volunteer residents who had never performed fiberoptic bronchoscopy were randomly divided into a training box group (n = 20) and a control group (n = 20). After trained box training and traditional video teaching respectively, Fiberoptic bronchoscopy was performed on advanced simulators to assess endotracheal intubation, and intubation time was compared between the two groups. Results The fiberoptic bronchoscope passed all the holes in the training box smoothly, and the microscopic holes were arranged in the same position as the real human trachea or bronchial opening. All trainee residencies were able to complete bronchofibroscopic tracheal intubation, but the time to complete intubation in the training group was (55.7 ± 10.2) s, significantly less than that in the control group [(69.3 ± 8.9) s, P <0.001 ]. Conclusion The fiberoptic bronchus training box is simple and practical. It is scientific and can be used to train advanced bronchoscopy skills. The training effect is remarkable.