目的:探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法:采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象,所有对象培训周期均为3个月,分为乳化劈核教学组和压核进钩劈核教学组,统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数,培训结束时对学员进行猪眼手术操作考核并记录评分,采用问卷调查对两种教学方式进行评价。结果:压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69(19,50)个,低于乳化劈核教学组的49.86(29,66)个(U=-3.08,P<0.05);压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13(31,79)个,低于乳化劈核教学组73.14(50,90)个(U=-2.66,P<0.05);压核进钩劈核教学组一次性完整完成二分核的次数为14.75(9,22)次,高于乳化劈核教学组6.79(3,14)(U=4.02,P<0.05);压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50(3,5),高于乳化劈核教学组的3.71(2,5)次(U=2.23,P<0.05);完整手术考核总分平均分为29.00(23,33)分,高于乳化劈核教学组的23.07(19,28)分(U=3.98,P<0.05)。培训结束时,压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31(15,20)分,高于乳化劈核教学组15.07(12,18)(U=3.69,P<0.05)。结论:核进钩劈核技术有助于学员更快地掌握碎核技术,缩短白内障超声乳化摘除手术的学习曲线,增强学习白内障手术的信心,提高超声乳化白内障吸除术的教学效果和满意度。
Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery.