【摘要】 目的研究基于混合现实(mixed reality,MR)技术的侧脑室穿刺训练系统在医学教育培训中的应用。方法利用1例侧脑室轻度扩大患者颅脑CT、MRI扫描所得的DICOM数据,经计算机图像数据处理、3D虚拟模型制作,导入虚拟现实软件并利用MR技术,结合摄像头目标追踪定位与二维码标记物空间配准技术,设计一套经济实用、操作简便及安全有效的移动MR侧脑室穿刺训练系统,用于年轻医生培训。选取2017年8月至2018年8月在本科室学习的年轻医师80名作为研究对象(每人学习时间为1个月)分为A、B两组,每组40人。A组为常规教学,B组为使用MR侧脑室穿刺训练系统教学,手术训练后对医生进行问卷调查,统计模拟手术操作成功率。结果 B组接受过MR侧脑室穿刺训练的医生,经问卷调查统计,对脑室解剖结构的掌握程度、对穿刺点的选取、侧脑室穿刺空间突破感的体验、对穿刺手术操作的自信心均比只接受常规培训的医生高。在模拟穿刺手术时,A组第一次穿刺的成功率93.3%(37/40)显著高于A组42.5%(17/40,χ~2=22.792,P <0.05)。结论利用侧脑室穿刺训练模型培训具有显著效果,其虚实结合的立体视觉效果,可辅助使用者对颅脑病变进行准确定位,使年轻医生快速掌握穿刺技术、提高手术成功率。更进一步,该技术可指导神经外科医生开展个性化、微创化和精准化的手术治疗、临床手术教学等。更多还原

【Abstract】 Objective To study the application of lateral ventricle puncture training system based on mixed reality(MR) technology in medical education and training. Methods The DICOM data of a patient with mild expansion of lateral ventricle were obtained by CT scan and MRI. The image data were processed by computer to establish 3 D virtual model, which was imported to the virtual reality software. A economical, user-friendly and effective mobile MR lateral ventricle puncture training model was designed by using the MR technology combined with camera target positioning and QR code tracking. Eighty young interns in our neurosurgery department from August 2017 to August 2018(period: one month) were selected as participants.They were randomly divided into two groups: group A(conventional training) and group B(simulated training) with 40 participants in each group. A questionnaire survey was conducted after the training, and the success rate of surgery was collected. Results The doctors in group B who had received MR lateral ventricle puncture training had higher mastery degree of lateral ventricle anatomy, proficiency in puncture procedure, and confidence in hands-on training than those who only received conventional training. The first-pass success rate of puncture in group B was significantly higher than that in group A(93.3% v.s. 42.5%, χ~2=22.792, P< 0.05). Conclusion MR lateral ventricle puncture training model is significantly effective. The stereoscopic visual effects mixed with virtual and real-world objects assist users to accurately locate craniocerebral lesions, enabling young doctors to quickly master the puncture techniques and improving the success rate of surgery. Furthermore, it can guide neurosurgeons to carry out personalized, minimally invasive and precise surgical practice and teaching.更多还原