虚拟实际技术在经股动脉全脑血管造影培训中的应用

目的研究虚拟实际技术（virtualreality，vn）在对无介入操作基础的初学者进行经股动脉全脑血管造影培训中的作用。方法采用随机配对的研究方法，将24名无介入操作经历的学员按照年龄、性别、学科背景等因素分为VR组和对照组（各12名）。对照组学员按照传统方法进行跟台培训；VR组学员采用模拟器进行培训，之后以助手身份参加1台全脑血管造影术。培训结束后。vR组学员需在模拟器上接受由带教教员实施的造影考核，同时两组均接受由专家盲评的实际血管造影操作考核；都采用改良的手术技能评价量表评分。两组实际造影考核成绩采用配对样本t检验。VR组的模拟器考核和实际造影考核成绩采用Pearson相关性分析，以P〈0．05为差异具有统计学意义。结果vR组学员模拟器和实际血管造影考核的平均成绩分别为（27．6±3．6）分和（26．4±3．8）分，对照组实际血管造影考核的平均成绩为（21．2±3．4）分。VR组实际血管造影和模拟器上造影考核成绩显著正相关（r=0．825，P=0．001），且平均成绩明显优于对照组（P=-0．010）。结论利用VR培训的技能可以顺利向实际操作迁移，利用VR可以提高无介入操作基础的初学者的脑血管造影技能。

Application of virtual reality stimulation in the training of transfemoral cerebral angiography

Objective To clarify the role of the virtual reality （VR） in the training of trans- femoral cerebral angiography for novices without any experience of intravascular manipulation. Methods Twenty-four novices without experiences of intravascular manipulation were divided into 2 groups （VR group or control group） with random pair method concerning the age, gender and subjects. The par- ticipants in control group were trained in routine manners while those in VR group practiced on a simulator and subsequently participated in real angiography once as assistants. Real angiography tests were performed for all participants after the training session and additional angiography tests were per- formed for VR group just after the stimulation session on the simulator. Real angiography tests were supervised and scored according to a modified rating scale by neuroradiological experts who were blinded to the novices＇ training procedures. Difference between the real test performance of the two groups were compared by pared-samples t test, while the correlation between the performance of the real tests and simulator tests of VR group was proved by Pearson correlation analysis. P〈0.05 was con-sidered statistically significant. Results The mean scores of VR group were （27.6± 3.6） and （26.4 ± 3.8） in the tests on simulator and real angiography tests respectively, while score of control group was （21.2 ± 3.4） in the real angiography tests. A positive correlation was revealed in VR group between performance on the simulator and that on real patients （r=0.825, P=0.001）. Real performance of the VR group was significantly better than that of control group （P=0.010）. Conclusions Virtual reality could ensure transfer of acquired endovascnlar skills from simulators to patients so as to become a valid tool for novices to improve the interventional techniques in tranfemoral cerebral angiography.