WO2023093219A1 - 经皮肾镜碎石取石术训练模型及其制备方法 - Google Patents

经皮肾镜碎石取石术训练模型及其制备方法 Download PDF

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WO2023093219A1
WO2023093219A1 PCT/CN2022/118047 CN2022118047W WO2023093219A1 WO 2023093219 A1 WO2023093219 A1 WO 2023093219A1 CN 2022118047 W CN2022118047 W CN 2022118047W WO 2023093219 A1 WO2023093219 A1 WO 2023093219A1
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kidney
fat
training model
training
simulated
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PCT/CN2022/118047
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English (en)
French (fr)
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李微
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北京博医时代医疗科技有限公司
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Publication of WO2023093219A1 publication Critical patent/WO2023093219A1/zh

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    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B9/00—Simulators for teaching or training purposes
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine

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  • the invention relates to the field of medical technology, in particular to a percutaneous nephrolithotripsy training model and a preparation method thereof.
  • the current training methods for doctors are as follows: 1) The use of dry modules (bean clamping, ferrule, perforation, paper cutting, silicone imitation meat, etc.) can only train basic abilities such as spatial sense conversion, hand-eye coordination, and hand coordination, and the skill coverage is small. , cannot meet the needs of human surgical operations (such as the use of energy equipment and surgical operation steps, etc.); 2) Although a single isolated organ can allow doctors to train real touch and energy equipment, it lacks lesions and distortion, which can only allow doctors to Practice individual techniques such as suturing and cutting; 3) Although 3D simulators are relatively convenient, human tissue is a complex multi-layer material, and its properties depend on the number of layers, thickness of layers, direction of muscle fibers, humidity, temperature, etc.
  • the first object of the present invention is to provide a percutaneous nephrolithotripsy training model to solve at least one of the above problems.
  • the second object of the present invention is to provide a method for preparing a percutaneous nephrolithotomy training model, which is simple, convenient and low in cost.
  • the present invention provides a percutaneous nephrolithotripsy training model, comprising a container, an ultrasonic-transparent material, simulated fat and a kidney; the ultrasonic-transmissible material is filled in the container; the simulated The fat wraps the kidney and is fixed in the ultrasound-permeable material; calculi are fixed in the calices of the kidney; the simulated fat includes at least one of chicken fat, suet or animal fat.
  • the ultrasound-permeable material includes at least one of agar gel, silica gel or fat.
  • the thickness of the simulated fat is 0.5-1 cm.
  • kidneys are derived from pigs or sheep.
  • the particle size of the stones is 0.5-2.5 cm.
  • the stone is fixed in the upper, middle or lower calices of the kidney.
  • the kidney is filled with a solution; preferably, the solution includes water; preferably, the solution contains an indicator; preferably, the indicator includes methylene blue solution.
  • the ureter of the kidney is connected with a perfusion tube, and the perfusion tube is used for filling the kidney solution.
  • the present invention provides a method for making a percutaneous nephrolithotomy training model, comprising the following steps: a. opening the kidney, placing stones in the calices, and closing the kidney; b. obtaining the Wrap the simulated fat in the kidney, and then place it in a container; c. Fill the container described in step b with an ultrasound-permeable material to prepare a percutaneous nephrolithotripsy training model.
  • the way of closing the kidney includes suturing or gluing.
  • a medical coupling agent is used to fit the kidney and the simulated fat.
  • the percutaneous nephrolithotripsy training model provided by the present invention includes containers, ultrasound-permeable materials, simulated fat and kidneys, wherein the ultrasound-transmittable materials are filled in In the container, the kidney is wrapped with simulated fat and fixed in ultrasound-permeable materials.
  • the simulated fat includes chicken fat, suet or animal fat, which can fully simulate the texture of perirenal fat and the filling of perirenal substances; stones are fixed in the calices of the kidney.
  • the training model of the present invention is easy to obtain materials.
  • the main raw material is isolated animal kidneys, which fully simulates the touch and force feedback of real operations, and can be used for training in kidney ultrasound image recognition, puncture, expansion, and stone crushing, so that medical staff can get real training.
  • the tactility of skill training can improve surgical skills; and the training environment of the training model is simple, saving space, cost, labor and other inputs, and realizing routine surgical training.
  • the manufacturing method of the percutaneous nephrolithotomy lithotripsy training model provided by the present invention is simple and fast, convenient to obtain materials, and low in cost.
  • Fig. 1 is a percutaneous nephrolithotomy training model provided by the present invention.
  • Example 1 (1) Select a pig kidney with a ureter length of 2 cm; (2) Select stones with a diameter of 0.5-0.8 cm, which can be irregular; (3) Open the dorsal incision of the renal pelvis for 1 cm, and place stones with a diameter of 0.5-0.8 cm (4) Suture the incision on the dorsal side of the renal pelvis; (5) Bind the opening end of the end of the ureter to the perfusion head and perfusion tube, and the perfusion length is 5cm; (6) Chicken oil, uniform in thickness (thinner , about 7mm); (7) Wrap the chicken oil completely on the surface of the kidney, and use a medical coupling agent to ensure that the kidney and the chicken oil fit tightly; (8) Take 25g of agar and 1000g of water (ratio 1:40), boil, Let it stand at 70°C; (9) Tilt the kidney at 30° and place it in a 20*30*20 box; (10) Introduce the rested agar into the box with the kidney and let it stand for 15-20 minutes.
  • Coagulation (11) Put 300ml of clear water in a 500ml infusion bag, 2ml of melanin solution, connect the infusion tube to the kidney perfusion tube, and pour the solution into the kidney when in use.
  • the prepared model is shown in Figure 1.
  • Example 2 (1) Select a sheep kidney with a ureter length of 3 cm; (2) Select stones with a diameter of 0.5-2 cm, which can be irregular; (3) Open a 2.5 cm incision on the dorsal side of the renal pelvis, and place stones with a diameter of 0.5-2 cm into the In the upper, middle and lower calices; (4) Adhesively close the dorsal incision of the renal pelvis; (5) Bind the opening end of the end of the ureter to the perfusion head and perfusion tube, and the perfusion length is 8cm; (6) Suet, with uniform thickness (thinner , about 5mm); (7) Wrap the suet completely on the surface of the kidney, and use a medical coupling agent to ensure a tight fit between the kidney and the suet; (8) Take 1500ml of A and B silica gels, mix them evenly, and let stand; (9 ) Tilt the kidney at 30° and place it in a 20*30*20 box; (10) Introduce the static silica gel into the box containing
  • Example 3 (1) Select a pig kidney with a ureter length of 4 cm; (2) Select stones with a diameter of 0.5-2.5 cm, which can be irregular; (3) Open the dorsal incision of the renal pelvis for 3 cm, and place stones with a diameter of 0.5-2.5 cm (4) Suture the dorsal incision of the renal pelvis; (5) Bind the opening end of the end of the ureter with the perfusion head and perfusion tube, and the perfusion length is 7cm; (6) Animal fat, uniform in thickness (thinner , 10mm); (7) Wrap the animal fat completely on the surface of the kidney, and use a medical coupling agent to ensure a tight fit between the kidney and the fat; (8) Tilt the kidney at 30° and place it in a 20*30*20 box; (9) Introduce animal fat into the box containing the kidney and fix it; (10) Put 300ml of clean water and 2ml of melanin into the 500ml infusion bag, connect the infusion tube to the kidney perfusion tube, and pour the
  • the present invention provides a percutaneous nephrolithotripsy training model, comprising a container, an ultrasonic-transparent material, simulated fat and a kidney; the ultrasonic-transmissible material is filled in the container; the simulated The fat wraps the kidney and is fixed in the ultrasound-permeable material; calculi are fixed in the calices of the kidney; the simulated fat includes at least one of chicken fat, suet or animal fat. Among them, chicken fat and suet can fully simulate the texture of perirenal fat, and the filling of perirenal substances can clearly display ultrasound images of stones.
  • the container is used to carry the ultrasound-transparent material, and its material and size are not specifically limited.
  • it can be a box of 20*30*20.
  • the box is made according to the shape of the back of the human body in prone position, as shown in Figure 1 shown.
  • the ultrasound-permeable material is a material that can transmit ultrasound without affecting the observation of the kidney, and is used for fixing the kidney and filling the distance from the kidney to the back of the human body.
  • simulated fat is used to simulate adipose tissue around the kidney.
  • Stones are solid masses formed in the lumen of ducts or lumens of luminal organs (such as kidneys, ureters, gallbladder or bladder, etc.) in humans or animals.
  • real stones on animals or artificially prepared simulated stones can be used.
  • raw materials such as alginate and limestone can be used to make stones.
  • the method for preparing stones using alginate can be, for example: alginic acid
  • the salt material and water are in a mass ratio of 22:10, add water to the alginate and stir quickly, stir evenly within 45 seconds, let stand to solidify, trim and solidify to the required stone size.
  • the present invention does not specifically limit the shape of the stone, and its shape can be irregular.
  • the percutaneous nephrolithotomy lithotripsy training model of the present invention has the following advantages: (1) The kidney is an isolated animal tissue and organ, so doctors can obtain feedback on the real training operation touch and strength on this training model; (2) Through the construction of lesions, doctors can realize ultrasound image recognition, puncture, dilation, lithotripsy and other training on this model; (3) It is convenient to obtain materials, which fully ensures that doctors can repeat training many times to achieve sufficient skill proficiency; (4) ) The material is easy to obtain and economical, which fully guarantees that this training method can be popularized; (5) As an isolated animal organ, this model is easy to use, which not only saves space, cost, labor and other inputs, but also realizes routine training.
  • the ultrasound-permeable material includes at least one of agar gel, silica gel or fat.
  • Agar gel is a gel mixed with agar and water. For example, it can be obtained by mixing agar and water with a mass ratio of 1:40. Agar gel is liquid at high temperature and solid at room temperature. Fill the container with liquid agar gel and cool it. A solid agarose gel is obtained, enabling full filling of the container.
  • Agar gel, silica gel or fat are ultrasound-permeable materials, which do not affect the observation of kidney stones, and at the same time can achieve fixation of the kidney.
  • the thickness of the simulated fat can be, for example, but not limited to 0.5cm, 0.6cm, 0.7cm, 0.8cm, 0.9cm or 1cm, preferably 0.7cm, within this range, the simulated fat The thickness is close to the fat thickness around the actual kidney, which can better simulate the fat tissue around the kidney.
  • the kidney is from pig or sheep.
  • the structure of pig and sheep kidney tissue is closer to human kidney, so it is preferably from pig or sheep kidney tissue.
  • the particle size of the stones may be, for example, but not limited to 0.5 cm, 1 cm, 1.5 cm, 2 cm or 2.5 cm.
  • the stone is fixed in the upper, middle or lower calices of the kidney. Calculi in the kidney usually occur in the renal calyces, and the renal calices are divided into upper, middle, or lower calyces. Therefore, it is preferable to fix the stones in the upper, middle, or lower calices of the kidney to achieve repeated training in surgery.
  • the kidney is filled with solution.
  • the actual kidney contains urine.
  • this model simulates the actual kidney by filling the kidney with solution.
  • the solution includes water
  • the filling solution is not specifically limited in the present invention, as long as it can realize the filling of the kidney and the simulation of urine.
  • the solution contains an indicator.
  • the indicator can be used to indicate whether the acupuncture position is correct or not during the operation training process, so as to facilitate the operation training.
  • the indicator includes methylene blue solution.
  • the ureter of the kidney is connected with a perfusion tube, and the perfusion tube is used for filling the kidney solution.
  • the present invention provides a method for making a percutaneous nephrolithotomy training model, comprising the following steps: a. opening the kidney, placing stones in the calices, and closing the kidney; b. obtaining the Wrap the simulated fat in the kidney, and then place it in a container; c. Fill the container described in step b with an ultrasound-permeable material to prepare a percutaneous nephrolithotripsy training model.
  • the angle at which the kidney is placed in the container can be placed with reference to the position of the kidney in the human body, for example, the kidney is placed in the container at an angle of 30 degrees.
  • the manufacturing method of the percutaneous nephrolithotomy lithotripsy training model provided by the present invention is simple and fast, convenient to obtain materials, and low in cost.
  • the means of closing the kidney include but not limited to suture or glue, or other means known to those skilled in the art that can be used to close and fix the kidney.
  • the kidney and the simulated fat are bonded with a medical coupling agent.
  • the medical couplant can make the kidney and the simulated fat closely fit to avoid affecting the ultrasound observation of stones.

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Abstract

提供一种经皮肾镜碎石取石术训练模型及其制备方法，涉及医疗技术领域。经皮肾镜碎石取石术训练模型包括容器、可透超声材料、模拟脂肪和肾脏，其中，可透超声材料填充在容器中，模拟脂肪包裹肾脏并固定于可透超声材料中，模拟脂肪包括鸡油、板油或动物脂肪，可充分模拟肾周脂肪质感以及肾周物质的填充；肾脏的肾盏中固定有结石。该训练模型取材方便，充分模拟真实操作的触感和力度反馈，可用于肾脏超声的影像识别、穿刺、扩张、碎石等培训，使医护人员得到真实的技能训练触感，提升手术技能；该训练模型的训练环境要求简单，节省场地、人工等投入，实现手术训练日常化。

Description

经皮肾镜碎石取石术训练模型及其制备方法 技术领域
本发明涉医疗技术领域，尤其是涉及一种经皮肾镜碎石取石术训练模型及其制备方法。
 背景技术
当代科技发展迅猛，医学技术日新月异，但目前外科医生大多仍采用“师徒带教”、“以术代练”的教学模式，因此导致医生动手机会严重不足，只有改变在病人身上训练技能的传统模式，才能为医生提供充足的技能积累机会，同时降低行医的风险。手术对于医生的操作熟练度有着极高的要求，如果想让医生获得有效的技能积累，就需要大量、逼真的训练。
目前医生的训练方法有：1）采用干式模块（夹豆、套圈、穿孔、剪纸、硅胶仿肉等）只能训练到空间感转换、手眼协调、双手协调等基本能力，技能覆盖范围小，不能满足人体手术操作的需要（比如能量器械设备的使用和手术操作步骤等）；2）单个离体器官虽然可以让医生训练到真实触感和能量设备，但是缺少病灶，失真，仅能让医生练习缝合、切割等单项技术；3）3D模拟器虽然相对便利，但人体组织是复杂的多层材料，并且由于其性质取决于层的数量、层的厚度、肌肉纤维的走向、湿度，温度等，所以3D模拟的操作触感一直不能达到临床需求；4）动物手术操作需要动物手术室、动物临时饲养间、麻醉设备等配套条件，场地、人员、设备投入成本高，便利性小，没有形成日常训练的可操作性，此外像猪的离体肾脏不能为医生提供肾周脂肪包裹环境及肾囊肿的病理状态；5）本方法为医生提供带有病灶结构的模型制作方法，使医生得到真实的技能训练触感，提升手术技能；同时取材便利、训练环境要求简单，节省场地、成本、人工等投入，让医生实现日常化训练，获得充足技能积累。
有鉴于此，特提出本发明。
 技术问题
本发明的第一目的在于提供一种经皮肾镜碎石取石术训练模型，以解决上述问题中的至少一种。
本发明的第二目的在于提供一种经皮肾镜碎石取石术训练模型的制备方法，该方法简单、方便、成本低。
 技术解决方案
第一方面，本发明提供了一种经皮肾镜碎石取石术训练模型，包括容器、可透超声材料、模拟脂肪和肾脏；所述可透超声材料填充在所述容器中；所述模拟脂肪包裹所述肾脏并固定于可透超声材料中；所述肾脏的肾盏中固定有结石；所述模拟脂肪包括鸡油、板油或动物脂肪中的至少一种。
作为进一步技术方案，所述可透超声材料包括琼脂凝胶、硅胶或脂肪中的至少一种。
作为进一步技术方案，所述模拟脂肪的厚度为0.5~1cm。
作为进一步技术方案，所述肾脏来源于猪或羊。
作为进一步技术方案，所述结石的粒径为0.5~2.5cm。
优选地，所述结石固定于肾脏的上盏、中盏或下盏内。
作为进一步技术方案，所述肾脏填充溶液；优选地，所述溶液包括水；优选地，所述溶液中含有指示剂；优选地，所述指示剂包括美兰液剂。
作为进一步技术方案，所述肾脏的输尿管连接有灌注管，所述灌注管用于肾脏溶液的填充。
第二方面，本发明提供了一种经皮肾镜碎石取石术训练模型的制作方法，包括以下步骤：a. 打开肾脏，在肾盏中置入结石，闭合肾脏；b. 将a步骤得到的肾脏包裹模拟脂肪，然后置于容器中；c. 向b步骤所述容器中填充可透超声材料，制备得到经皮肾镜碎石取石术训练模型。
作为进一步技术方案，所述闭合肾脏的方式包括缝合或胶粘。
作为进一步技术方案，所述肾脏和模拟脂肪之间采用医用耦合剂贴合。
 有益效果
与现有技术相比，本发明具有如下有益效果：本发明提供的经皮肾镜碎石取石术训练模型，包括容器、可透超声材料、模拟脂肪和肾脏，其中，可透超声材料填充在容器中，模拟脂肪包裹肾脏并固定于可透超声材料中，模拟脂肪包括鸡油、板油或动物脂肪，可充分模拟肾周脂肪质感以及肾周物质的填充；肾脏的肾盏中固定有结石。本发明的训练模型取材方便，以离体的动物肾脏为主要原料，充分模拟真实操作的触感和力度反馈，可用于肾脏超声的影像识别、穿刺、扩张、碎石等培训，使医护人员得到真实的技能训练触感，提升手术技能；而且该训练模型的训练环境要求简单，节省场地、成本、人工等投入，实现手术训练日常化。
本发明提供的经皮肾镜碎石取石术训练模型的制作方法，简单快捷，取材方便，成本低。
 附图说明
为了更清楚地说明本发明具体实施方式或现有技术中的技术方案，下面将对具体实施方式或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图是本发明的一些实施方式，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1为本发明提供的经皮肾镜碎石取石术训练模型。
 本发明的最佳实施方式
下面通过具体的实施例和对比例进一步说明本发明，但是，应当理解为，这些实施例仅仅是用于更详细地说明之用，而不应理解为用于以任何形式限制本发明。
实施例1 （1）选取猪的肾脏带输尿管长度2cm；（2）选取直径0.5-0.8cm的结石，可不规则；（3）打开肾盂背侧切口1cm，将直径0.5-0.8cm的结石分别置入上、中、下盏内；（4）缝合肾盂背侧切口；（5）将输尿管末尾开口端，绑定灌注头及灌注管，灌注长度5cm；（6）鸡油，厚薄均匀（偏薄，约7mm）；（7）将鸡油完整包裹在肾脏表面，使用医用耦合剂保证肾脏及鸡油之间贴合紧密；（8）取25g琼脂及1000g水（比例1:40），煮沸，静置至70℃；（9）将肾脏倾斜30°，放置在20*30*20的盒子内；（10）将静置后的琼脂导入装有肾脏的盒子内，静置15-20分钟，凝固；（11）500ml输液袋置入清水300ml，美兰液剂2ml，连接输液管至肾脏灌注管，使用时向肾脏中灌入溶液。制备得到的模型如图1所示。
实施例2 （1）选取羊的肾脏带输尿管长度3cm；（2）选取直径0.5-2cm的结石，可不规则；（3）打开肾盂背侧切口2.5cm，将直径0.5-2cm的结石分别置入上、中、下盏内；（4）胶粘闭合肾盂背侧切口；（5）将输尿管末尾开口端，绑定灌注头及灌注管，灌注长度8cm；（6）板油，厚薄均匀（偏薄，约5mm）；（7）将板油完整包裹在肾脏表面，使用医用耦合剂保证肾脏及板油之间贴合紧密；（8）取A、B硅胶各1500ml，混合搅拌均匀，静置；（9）将肾脏倾斜30°，放置在20*30*20的盒子内；（10）将静置后的硅胶导入装有肾脏的盒子内，静置4-6小时，凝固；（11）500ml输液袋置入清水300ml，美兰液剂2ml，连接输液管至肾脏灌注管，使用时向肾脏中灌入溶液。
实施例3 （1）选取猪的肾脏带输尿管长度4cm；（2）选取直径0.5-2.5cm的结石，可不规则；（3）打开肾盂背侧切口3cm，将直径0.5-2.5cm的结石分别置入上、中、下盏内；（4）缝合肾盂背侧切口；（5）将输尿管末尾开口端，绑定灌注头及灌注管，灌注长度7cm；（6）动物脂肪，厚薄均匀（偏薄，10mm）；（7）将动物脂肪完整包裹在肾脏表面，使用医用耦合剂保证肾脏及脂肪之间贴合紧密；（8）将肾脏倾斜30°，放置在20*30*20的盒子内；（9）将动物脂肪导入装有肾脏的盒子内，固定；（10）500ml输液袋置入清水300ml，美兰液剂2ml，连接输液管至肾脏灌注管，使用时向肾脏中灌入溶液。
最后应说明的是：以上各实施例仅用以说明本发明的技术方案，而非对其限制；尽管参照前述各实施例对本发明进行了详细的说明，本领域的普通技术人员应当理解：其依然可以对前述各实施例所记载的技术方案进行修改，或者对其中部分或者全部技术特征进行等同替换；而这些修改或者替换，并不使相应技术方案的本质脱离本发明各实施例技术方案的范围。
 本发明的实施方式
下面将结合实施方式和实施例对本发明的实施方案进行详细描述，但是本领域技术人员将会理解，下列实施方式和实施例仅用于说明本发明，而不应视为限制本发明的范围。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。未注明具体条件者，按照常规条件或制造商建议的条件进行。所用试剂或仪器未注明生产厂商者，均为可以通过市售购买获得的常规产品。
第一方面，本发明提供了一种经皮肾镜碎石取石术训练模型，包括容器、可透超声材料、模拟脂肪和肾脏；所述可透超声材料填充在所述容器中；所述模拟脂肪包裹所述肾脏并固定于可透超声材料中；所述肾脏的肾盏中固定有结石；所述模拟脂肪包括鸡油、板油或动物脂肪中的至少一种。其中鸡油和板油能够充分模拟肾周脂肪质感，肾周物质的填充，可清晰显示结石超声影像。
本发明中，容器用于承载可透超声材料，对其材料及尺寸不作具体限制，例如可以为20*30*20的盒子，优选地，根据人体俯卧位时的背部形状制作盒子，如图1所示。
本发明中，可透超声材料为能够透过超声的材料，而不影响对于肾脏观察的材料，用于肾脏的固定和肾脏至人体背部距离的填充。
本发明中，模拟脂肪为用于模拟肾脏周边的脂肪组织。
结石是人体或动物体内的导管腔中或腔性器官（如肾脏、输尿管、胆囊或膀胱等）的腔中形成的固体块状物。本发明中，可以采用动物身上真实的结石，或者人工制备得到的模拟结石，例如可以使用藻酸盐、石灰石等原料制作成结石，其中，采用海藻酸盐制备结石的方法例如可以为：藻酸盐材料与水按照质量比例22:10，藻酸盐内加水快速搅拌，45秒内搅拌均匀，静置凝固，修剪凝固为所需结石大小。本发明对于结石的形状不作具体限制，其形状可以不规则。
本发明的经皮肾镜碎石取石术训练模型具有如下优点：（1）肾脏属于离体动物组织器官，所以医生可在本训练模型上获得真实的训练操作触感和力度的反馈；（2）通过病灶的搭建，医生可以在本模型上实现超声的影像识别、穿刺、扩张、碎石等培训；（3）取材便利，充分保证医生能多次反复训练，达到充足的技能熟练度；（4）材料获取便利、经济实惠，充分保证本训练方法可以普及推广；（5）作为离体动物器官，本模型使用便利，既节省场地、成本、人工等投入，也实现训练日常化。
在一些优选的实施方式中，所述可透超声材料包括琼脂凝胶、硅胶或脂肪中的至少一种。
琼脂胶为琼脂与水混合的凝胶，例如可以通过琼脂和水以1:40的质量比混合得到，琼脂胶在高温下为液态，室温下为固态，以液态的琼脂胶填充容器，冷却后得到固态的琼脂胶，能够实现容器的充分填充。
琼脂凝胶、硅胶或脂肪为可透超声材料，不影响对肾脏结石的观察，同时能够实现对肾脏的固定。
在一些优选的实施方式中，所述模拟脂肪的厚度例如可以为，但不限于0.5cm、0.6cm、0.7cm、0.8cm、0.9cm或1cm，优选为0.7cm，在此范围内，模拟脂肪的厚度与实际肾脏周边的脂肪厚度接近，能够更好的模拟肾脏周边脂肪组织。
在一些优选的实施方式中，所述肾脏来源于猪或羊。猪和羊的肾脏组织的结构与人体肾脏更为接近，因此优选来自于猪或羊的肾脏组织。
在一些优选的实施方式中，所述结石的粒径例如可以为，但不限于0.5cm、1cm、1.5cm、2cm或2.5cm。
在一些优选的实施方式中，所述结石固定于肾脏的上盏、中盏或下盏内。肾脏中结石通常产生在肾盏中，而肾盏分为上盏、中盏或下盏，因此优选将结石固定于肾的上盏、中盏或下盏中，实现手术的反复训练。
在一些优选的实施方式中，所述肾脏填充溶液。实际肾脏中是含有尿液的，为了充分模拟实际病灶，本模型通过在肾脏中填充溶液以模拟实际状态下的肾脏。
优选地，所述溶液包括水，本发明中对于填充的溶液不作具体限制，能够实现肾脏的填充和尿液的模拟即可。
优选地，所述溶液中含有指示剂。指示剂能够用于指示手术训练过程中针刺位置的正确与否，方便手术训练。
优选地，所述指示剂包括美兰液剂。
在一些优选的实施方式中，所述肾脏的输尿管连接有灌注管，所述灌注管用于肾脏溶液的填充。
第二方面，本发明提供了一种经皮肾镜碎石取石术训练模型的制作方法，包括以下步骤：a. 打开肾脏，在肾盏中置入结石，闭合肾脏；b. 将a步骤得到的肾脏包裹模拟脂肪，然后置于容器中；c. 向b步骤所述容器中填充可透超声材料，制备得到经皮肾镜碎石取石术训练模型。
需要说明的是，肾脏置于容器中的角度可参照肾脏在人体中的位置进行摆放，例如将肾脏倾斜30度摆放于容器中。
本发明提供的经皮肾镜碎石取石术训练模型的制作方法，简单快捷，取材方便，成本低。
在一些优选的实施方式中，所述闭合肾脏的方式包括但不限于缝合或胶粘，或者本领域技术人员所熟知的其他能够用于闭合固定肾脏的方式。
在一些优选的实施方式中，所述肾脏和模拟脂肪之间采用医用耦合剂贴合。医用耦合剂能够使得肾脏和模拟脂肪紧密贴合，避免影响对结石的超声观察。

Claims (10)

  1. 一种经皮肾镜碎石取石术训练模型，其特征在于，包括容器、可透超声材料、模拟脂肪和肾脏；
    所述可透超声材料填充在所述容器中；所述模拟脂肪包裹所述肾脏并固定于可透超声材料中；
    所述肾脏的肾盏中固定有结石；
    所述模拟脂肪包括鸡油、板油或动物脂肪中的至少一种。
  2. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述可透超声材料包括琼脂凝胶、硅胶或脂肪中的至少一种。
  3. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述模拟脂肪的厚度为0.5~1cm。
  4. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述肾脏来源于猪或羊。
  5. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述结石的粒径为0.5~2.5cm；
    优选地，所述结石固定于肾脏的上盏、中盏或下盏内。
  6. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述肾脏填充溶液；
    优选地，溶液包括水；
    优选地，所述溶液中含有指示剂；
    优选地，所述指示剂包括美兰液剂。
  7. 根据权利要求1所述的经皮肾镜碎石取石术训练模型，其特征在于，所述肾脏的输尿管连接有灌注管，所述灌注管用于肾脏溶液的填充。
  8. 权利要求1-7任一项所述的经皮肾镜碎石取石术训练模型的制作方法，其特征在于，包括以下步骤：
    a. 打开肾脏，在肾盏中置入结石，闭合肾脏；
    b. 将a步骤得到的肾脏包裹模拟脂肪，然后置于容器中；
    c. 向b步骤所述容器中填充可透超声材料，制备得到经皮肾镜碎石取石术训练模型。
  9. 根据权利要求8所述的制作方法，其特征在于，所述闭合肾脏的方式包括缝合或胶粘。
  10. 根据权利要求8所述的制作方法，其特征在于，所述肾脏和模拟脂肪之间采用医用耦合剂贴合。
PCT/CN2022/118047 2021-11-29 2022-09-09 经皮肾镜碎石取石术训练模型及其制备方法 WO2023093219A1 (zh)

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