目的 探讨3D打印手术训练模型在肝脏微创手术术前医患沟通的应用效果。方法 选取2023年4月至2023年7月接受微创肝脏手术患者80例，按照时间先后顺序分组，2023年4月至2023年5月为对照组，2023年6月至2023年7月为观察组，每组各40例。观察组采用3D打印手术训练模型联合口述及CT或MRI影像进行术前医患沟通，对照组采用口述及CT或MRI影像进行术前医患沟通。比较两组医患沟通前、后焦虑、信息需求评分及疾病、手术认知度和满意度;术前1 d 6∶00(T0)、麻醉诱导前(T1)、手术结束患者完全清醒时(T2)、术后第1天6∶00(T3)、术后第3天6∶00(T4)不同时间点血清白细胞介素6(IL-6)、血管紧张素Ⅱ(ATⅡ)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)、平均动脉压(MAP)及心率(HR)各生理应激指标变化。结果 焦虑、手术信息需求评分及疾病、手术认知度和满意度:医患沟通后，观察组低于对照组，差异均有统计学意义(P<0。05)，观察组医患沟通后焦虑、手术信息需求评分低于沟通前，差异有统计学意义(P<0。001)。生理应激指标:T1、T2时间点，观察组低于对照组，差异均有统计学意义(P<0。05);两组内总体均数差异有统计学意义(P<0。001);与同组T0时间点相比，两组T1、T3、T4时间点均降低，其中观察组差异均有统计学意义(P<0。05)，对照组T3、T4时间点差异均有统计学意义(P<0。05);两组T2时间点均升高，其中对照组升高有统计学意义(P<0。05)。结论 3D打印手术训练模型联合口述及CT或MRI影像的术前医患沟通模式能有效降低肝脏微创手术患者心理、生理应激反应，提高患者对疾病、手术认知度及满意度。
Objective To explore the effectiveness of 3D printed surgical training models in preoperative doctor-patient communication for minimally invasive liver surgery.Methods From April 2023 to July 2023,80 cases underwent minimally invasive liver surgery were collected.Grouped in chronological order,cases from April 2023 to May 2023 were divided into the control group,and cases from June 2023 to July 2023 were divided into the observation group,with 40 cases in each group.The observation group used 3D printed surgical training model combined with oral description and images described by CT or MRI for preoperative doctor-patient communication,and the control group used oral description and images described by CT or MRI for preoperative doctor-patient communication.The two groups were compared in terms of pre-and post-doctor-patient communication anxiety,information need scores,and disease and surgery awareness and satisfaction,Serum interleukin 6(IL-6),angiotensin Ⅱ(AT Ⅱ),adrenocorticotropic hormone(ACTH),cortisol(Cor),mean arterial pressure(MAP),and heart rate(HR)were measured at different time points at 6:00 on the first preoperative day(T0),before induction of anesthesia(T1),at the end of the surgery when the patient was fully awake(T2),at 6:00 on the first postoperative day(T3),and at 6:00 on the third postoperative day(T4).Results Anxiety and surgical information need scores and disease and surgical awareness and satisfaction showed that after doctor-patient communication,the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The scores of anxiety and surgical information need in the observation group were lower than those before communication after doctor-patient communication,and the differences were statistically significant(P<0.001).Physiological stress indicators showed that the T1 and T2 time points in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The overall mean within the two groups was statistically different(P<0.001).Compared with the T0 time point of the same group,the T1,T3 and T4 time points of the two groups were lower,of which the differences of the observation group were statistically significant(P<0.05),and those of the control group were statistically significant(P<0.05).T2 time points were elevated in both groups,of which the elevation in the control group was statistically significant(P<0.05).Conclusion The preoperative doctor-patient communication mode of 3D-printed surgical training model combined with dictation and CT or MRI descriptive images can effectively reduce the psychological and physiological stress reactions of patients undergoing minimally invasive liver surgery,and improve the patients'cognition of and satisfaction with the disease and surgery.
3D printed modelLiverMinimally invasive surgeryPreoperative doctor-patient communication
万方数据
维普
