哈尔滨医科大学附属第一医院 消化内科，黑龙江 哈尔滨 150001
Department of Gastroenterology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
目的 研究标准结肠镜的直肠插入训练对胃镜初学者食管进镜能力的影响。方法 将8名无内镜经验的新手胃镜学员随机分配到两组。A组仅采用GI-BRONCH Mentor模拟器胃镜模块训练，B组完成模拟器胃镜模块训练后进行肠镜直肠插入训练。两组训练完成后立即进行食管进镜的测试。比较组间食管进镜完成率以及每一分解步骤的完成率。结果 B组的不能完成率低于A组（B组17.50%和A组36.25%，P < 0.05），独立完成率高于A组（B组63.75%和A组38.75%，P < 0.05）。分解步骤中，将内镜前段抵在左侧食管入口的完成情况，B组明显优于A组（B组97.47%和A组89.19%，P < 0.05）。结论 进行结肠镜直肠插入训练可以提高胃镜初学者的食管进镜能力，弥补了虚拟现实内镜模拟器口咽部真实性差的不足，是可推荐的培训方式。
Objective To study the effect of inserting to rectum with standard colonoscope on the esophageal intubation ability of novices at gastroscopy.Methods 8 novices without endoscopic experience were randomized to two groups. The group A received training with the upper GI endoscopy module of GI-BRONCH Mentor, and the group B received training of rectal insertion plus the upper GI endoscopy module. Esophageal intubation test was conducted immediately after the training of both groups. The completion rates of esophageal intubation and the rates of each step were compared.Results The failure rate of group B is lower than that of group A (group B 17.50% vs group A 36.25%, P < 0.05). The independent completion rate of group B is higher (group B 63.75% vs group A 38.75%, P < 0.05). Group B is superior than group A in terms of advancing the distal tip to the left esophageal entrance (group B 97.47% vs group A 89.19%, P < 0.05).Conclusion Rectal insertion improves the skills needed for esophageal intubation of novices and make up for the defect of poor authenticity of the oral cavity part and pharynx part of VR endoscope simulators. It is a recommended training method.