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目的:探讨胃镜、超声内镜( EUS)辅助腹腔镜治疗在胃间质瘤中的应用价值。方法采用腹腔镜治疗胃间质瘤患者145例,术前均接受胃镜检查,80例接受EUS检查。然后在胃镜和术中EUS引导下行腹腔镜胃间质瘤切除术。术后随访2~20个月。结果腹腔镜手术时间50~120 min、平均69.5 min,出血量50~150 mL、平均74.3 mL,8例中转开腹,无术中死亡病例。平均排气时间24.5 h,住院时间4~9 d、平均6.7 d。133例为良性单发肿瘤,12例为交界性肿瘤。129例胃间质瘤,16例为平滑肌瘤。病理切缘肿瘤检查均为阴性,瘤体直径(2.9±4.6) cm。术后随访2~20个月,未见肿瘤复发或远处转移。结论术前胃镜、超声内镜联合应用能够早期发现病变,初步判定胃间质瘤的性质、危险程度和周围组织的关系。术中腹腔镜、胃镜和EUS的联合可充分发挥微创治疗胃间质瘤的优势,减少并发症和术后复发,手术效果良好。 相似文献
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目的通过表象训练进行腹腔镜缝合技能教学并对考核结果进行量化评价,分析应用表象训练后对腹腔镜下缝合动作技能学习的影响。方法 36名研究对象随机分为3组:表象训练组、常规教学组及对照组各12名,按照不同的教学方法进行微创外科缝合技能的培训,在统一考核标准及条件下进行考核,得出数据并进行统计分析。结果表象训练组培训前和培训后考核成绩有明显差异(5.45±1.34vs14.32±3.78,P〈0.001),培训后考核与两周后考核成绩无明显差异(14.32±3.78vs14.02±6.21,P=0.887);常规教学组培训前和培训后考核成绩有明显差异(5.49±1.56vs15.84±5.64,P〈0.001),培训后考核和两周后考核成绩有明显差异(15.84±5.64vs12.47±2.88,P=0.048);对照组培训前和培训后考核成绩无明显差异(5.52±1.19vs6.82±2.36,P=0.054),培训后考核和两周后考核有明显差异(6.82±2.36vs5.39±0.78,P=0.048)。运用ONEWAYANOVA进行组间两两比较,在培训前考核中,与表象训练组相比较,常规教学组(P=0.951)和对照组(P=0.914)均无明显差异,常规教学组与对照组比较无明显差异(P=0.962);培训后考核,3个测试组考核结果有明显差异(P〈0.001),两两比较,常规教学组与表象训练组比较无明显差异(P=0.406),对照组与表象训练组比较有明显差异(P〈0.001),常规教学组与对照组比较也存在明显差异(P〈0.001);两周后考核,3个测试组考核结果有明显差异(P〈0.001);两两比较,与表象训练组相比常规教学组无(P=0.375),与对照组相比有明显差异有明显差异(P〈0.001),常规教学组与对照组比较有明显差异(P〈0.001)。结论表象训练能明显提高腹腔镜缝合技能培训效果,并有较好的持久性,是未来腹腔镜动作技能学习的新方法。 相似文献
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低剂量咪唑安定在上消化道内镜检查中的应用 总被引:22,自引:0,他引:22
患者对接受上消化道内镜检查与治疗操作常存在不同程度的焦虑与紧张心理,在接受检查与治疗操作时又确实有程度不同的咽部不适、呛咳、恶心、呕吐甚至疼痛等不适感,一方面难于很好地合作而影响了内镜检查与治疗过程,另一方面也给患者留下了不良的经历与回忆,可能将此不良的感受传染给其他患者,甚至会加倍地夸大其不适的感觉。因此,在术前适当给予镇静药物可能减轻患者的焦虑与紧张心理、提高患者接受内镜检查与治疗的耐受性。本研究目的是观察低剂量咪唑安定在内镜检查中的镇静作用及其安全性。 一、病例选择及分组:在接受胃镜检… 相似文献
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咽部疾病的临床表现常尢特异性,而上消化道内镜检查时医生常常为了减轻埘患者咽部的刺激,在未能清晰显示咽部结构的情况下就已将内镜插入患者食管,以至于咽喉部的病变易被遗漏,不能得到及时有效的诊治。 相似文献
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放大胃镜在胃癌及癌前病变诊断中的应用 总被引:1,自引:0,他引:1
房殿春 《现代消化及介入诊疗》2005,10(3):146-148
近年,伴随着电子内镜技术的进步,放大内镜在机械性能、放大倍数及图像清晰度等方面均有了很大改进。由于机械及光学性能的改进,开发出了附有变焦镜头(zoom)的放大内镜.其软性镜身的外径与普通电子胃镜完全相同;应用同一根镜子先进行常规检查,发现病变后可立即变焦即时进行放大观察,不需更换内镜.既不增加病人痛苦,又方便了医生.其代表者为奥林巴斯推出的GIF-Q240Z型放大内镜。由于电子及光学技术的进步。开发出了具有41~85万像素的高分辨率放大内镜,使得消化管黏膜的表面微细结构更为清晰,其代表者为富士能推出的EG-415ZH型放大内镜。 相似文献
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目的探讨无痛胃镜检查中采用内镜面罩给氧技术的可行性和安全性,并与通过鼻塞管给氧法相比较。方法60例胃镜检查患者均分为两组.通过内镜面罩给氧者为试验组(T组),通过鼻塞管给氧者为对照组(C组)。全部病例先静脉推注拘橼酸势太尼0.05mg,于20~50s内静脉注入丙泊酚2.5mg/kg,待患者意识消失后开始检查。在检查过程中分别检测血氧饱和度、血压、心率及操作时间,并对两组进行对比。结果血氧饱和度在对照组麻醉诱导后至检查结束期间明显降低.与诱导前相比差异有统计学意义(P〈0.05)。但在操作时间、心率、血压(收缩压和舒张压)方面两组间差异无统计学意义(P〉0.05)。结论辅以内镜面罩给氧进行无痛胃镜检查在维持生命体征指标上优于鼻塞管给氧,使无痛胃镜检查更为安全。 相似文献
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传统的肠镜培训模式已经无法适应如今消化内镜的快速发展以及患者对于内镜操作技术的高要求,磁性内镜成像系统ScopeGuide为内镜医师的肠镜培训提供了准确有用的辅助信息,使得肠镜技能培训更加专业和快捷。本文阐述了现有肠镜培训模式存在的问题以及磁性内镜成像系统的基本原理,重点论述了磁性内镜成像系统在肠镜培训中的应用。 相似文献
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胃镜外套管在急诊内镜处理上消化道出血中的价值 总被引:1,自引:1,他引:0
急性上消化道出血因其发病率和死亡率均较高,在临床上一直受到高度重视。急诊内镜处理上消化道出血往往发现部分患者胃内存有大量积血和食物残渣,视野不清,无法找到出血病灶进行有效止血而失败。我们近年来,在急诊内镜处理此类患者中应用胃镜外套管(专利号:ZL200720109495.7)取得显著效果,现报告如下。 相似文献
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套管法在上消化道异物内镜取出术中的应用 总被引:6,自引:0,他引:6
上消化道异物是临床上常见的急症,因吞入的异物种类不同,尤其是尖锐异物,在内镜治疗中易引起异物的嵌顿,导致操作困难及食管、咽喉壁的并发症的发生.我们采用套管法对我院3年中胃镜诊断的上消化道异物患者进行了治疗,取得了满意的效果. 相似文献
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Louis Harpham-Lockyer Faidon-Marios Laskaratos Pasquale Berlingieri Owen Epstein 《World journal of gastrointestinal endoscopy》2015,7(18):1287-1294
Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simula-tors and the long-term benefits of their use are also discussed. 相似文献
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Ta-Ko Huang Chi-Hsun Yang Yu-Hsin Hsieh Jen-Chyan Wang Chun-Cheng Hung 《The Kaohsiung journal of medical sciences》2018,34(4):243-248
The OSCE is a reliable evaluation method to estimate the preclinical examination of dental students. The most ideal assessment for OSCE is used the augmented reality simulator to evaluate. This literature review investigated a recently developed in virtual reality (VR) and augmented reality (AR) starting of the dental history to the progress of the dental skill. As result of the lacking of technology, it needs to depend on other device increasing the success rate and decreasing the risk of the surgery. The development of tracking unit changed the surgical and educational way. Clinical surgery is based on mature education. VR and AR simultaneously affected the skill of the training lesson and navigation system. Widely, the VR and AR not only applied in the dental training lesson and surgery, but also improved all field in our life. 相似文献
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目的 探讨消化内镜模拟机评估学习者内镜操作经验可能的应用价值.方法 50名学习者按照内镜工作经验分成初级组、中级组、高级组和专家级组,应用消化内镜模拟机中的手眼协调训练评估各组学习者的内镜操作技能,评估参数包括完成总时间、两次触击的间隔时间和触壁次数.结果 以胃镜操作经验分组时,学习者手眼协调训练完成总时间分别为(302.43±108.96)s、(188.00 ±59.88)s、135.00(40.00)s、150.00(69.00)s,两次触击的间隔时间分别为(14.29 ±5.47)s、(8.82 ±3.28)s、6.00(2.00)s、7.00(4.00)s,上述两个指标除了高级组与专家级组组间比较差异无统计学意义(P>0.05)以外,其他各组间比较差异均有统计学意义(P<0.01).以结肠镜操作经验分组时,学习者手眼协调训练完成总时间分别为220.00 (91.00)s、127.00(28.25)s、155.50 (81.00)s、150.00(58.50)s,组间比较差异均有统计学意义(P<0.01);两次触击的间隔时间分别为10.00(4.00)s、5.50(1.50)s、7.00(3.75)s、7.00(3.50)s,除了初级组与高级组比较以及中级组与专家级组比较差异无统计学意义(P>0.05)以外,其他各组间比较差异均有统计学意义(P <0.05或P<0.01).在触壁次数这一指标上,除了以胃镜操作经验进行分组的初级组与高级组间差异有统计学意义(P<0.05)外,其他以胃镜操作经验进行分组的各组间以及以结肠镜操作经验分组的各组间差异均无统计学意义(P>0.05).结论 消化内镜模拟机手眼协调训练的完成总时间可能可以作为实际操作内镜前陕速区分学习者内镜操作经验的一种方法,但对于高级与专家级的精确评估仍需其他指标进行补充. 相似文献
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基于现代战争胸部外伤伤情特点和战伤分级救治理论,本文提出利用虚拟现实技术(virtual reality,VR)辅助建立胸部战伤分级救治模式.VR具有提供沉浸式和交互式体验、规避安全风险等优势,利用VR设计个性化胸部战伤案例,在分级救治不同的阶段对伤情评估、诊断和处置进行培训和考核,更有利于提高野战条件下战士及卫生人员... 相似文献
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虚拟现实技术自20世纪80年代问世至今,已融入经济、教育、娱乐甚至军事等各个领域,为用户提供各种逼真体验。虚拟现实可以为操作者提供身临其境的沉浸感,在反复场景交互中,使操作者强化互动中所带来的感官刺激及场景中功能的学习。在近年各种疾病的临床康复治疗中,虚拟现实凭借以上优势,日益得到重视并已广泛应用于运动、平衡及认知等康复治疗中。脑卒中后肢体运动功能康复一直是康复领域的难点及热点,本文对比传统康复手段,综述了虚拟现实技术对脑卒中患者康复的优势、特点和不足,并展望虚拟现实技术对促进脑卒中患者康复的前景。 相似文献
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目的探讨三维虚拟现实导航技术(VR)对于胸腔镜下肺段切除术中及术后的影响。方法选取解放军总医院2016年10月至2017年2月中8例胸腔镜下肺段切除手术作为研究对象,随机分为VR辅助组和传统组,对比术中出血量、手术时间及术后恢复时间的差异。结果 VR组术中出血量较传统组明显减少(12.25±2.22 vs.60.25±9.74)ml,VR组手术时间较传统组显著缩短(84.50±5.57 vs.116.50±6.61)min;VR组术后恢复时间较传统组略有缩短(4.25±0.96 vs.8.00±0.82)d。(P0.05)。结论利用虚拟现实导航技术进行术前评估,详细制定手术计划,规划手术路线,术中实时导航,预显示重要解剖结构,切实减少了肺段切除手术的难度,对于肺段切除手术的普及具有重大意义。 相似文献
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Yasuyuki Shirai Tomoharu Yoshida Ryu Shiraishi Takeshi Okamoto Hiroki Nakamura Toshiya Harada Jun Nishikawa Isao Sakaida 《Journal of gastroenterology and hepatology》2008,23(7PT1):1046-1050
Background and Aim: Computer-based endoscopic simulators have been developed in recent years, and their usefulness has been reported. However, there is no blinded prospective randomized controlled study on esophagogastroduodenoscopy (EGD) training using virtual reality simulators. The present study aimed to assess the effectiveness of a computer-based simulator for basic training in EGD.
Methods: The GI-Mentor II simulator was used. The subjects were 20 hospital medical residents. After receiving an explanation regarding the fundamentals of endoscopy, 10 trainees were each randomized into a simulator group and a non-simulator group. The simulator group received 5 h of training with the GI-Mentor II plus bedside training, while the non-simulator group received bedside training. Subsequently, each subject performed endoscopy twice for assessment. Performance was evaluated according to a five-grade scale for a total of 11 items.
Results: The score was significantly higher in the skills required for insertion into the esophagus, passing from the esophagogastric junction (EGJ) to the antrum, passing through the pylorus, and examination of the duodenal bulb and the fornix.
Conclusions: The performance of endoscopy was improved by 5 h of simulator training. The simulator was more effective with regard to the items related to manipulation skills. Computer-based simulator training in EGD is useful for beginners. 相似文献
Methods: The GI-Mentor II simulator was used. The subjects were 20 hospital medical residents. After receiving an explanation regarding the fundamentals of endoscopy, 10 trainees were each randomized into a simulator group and a non-simulator group. The simulator group received 5 h of training with the GI-Mentor II plus bedside training, while the non-simulator group received bedside training. Subsequently, each subject performed endoscopy twice for assessment. Performance was evaluated according to a five-grade scale for a total of 11 items.
Results: The score was significantly higher in the skills required for insertion into the esophagus, passing from the esophagogastric junction (EGJ) to the antrum, passing through the pylorus, and examination of the duodenal bulb and the fornix.
Conclusions: The performance of endoscopy was improved by 5 h of simulator training. The simulator was more effective with regard to the items related to manipulation skills. Computer-based simulator training in EGD is useful for beginners. 相似文献
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《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2020,14(4):661-664
Background and aimsDuring COVID-19 pandemic, researchers are using innovative technologies for fast-tracking the development to end this menace. Virtual Reality (VR) also offers an imperative role for fighting this pandemic, through audiovisual-based virtual communication.MethodsA brief study on Virtual Reality and its applications for the COVID-19 pandemic is carried out by employing keywords as Virtual reality or VR and COVID-19 from the databases of SCOPUS, Google Scholar, PubMed, Web of science Academia and ResearchGate.ResultsVR is beneficial for remote sites for exploring telemedicine, planning, treatment, and controlling of the infections by providing proper awareness to the people regarding this disease.ConclusionsVR technology develops a platform to reduce the face to face interaction of doctors with the infected COVID-19 patients. Through live video streaming, it helps to improve surveillance systems on the ongoing situation. 相似文献