標準空間半規管模型在良性陣發性位置性眩暈教學中的應用

林萍　楊曉凱　倪伊婷　林一均

[摘要] 目的 探討在傳統教學模式基礎上結合標準空間半規管模型動畫演示及3D打印模型的新教學模式在良性陣發性位置性眩暈教學中的應用。 方法 將教學對象分為兩組，分別為2016年9月及2016年10月在我院神經內科輪轉實習的規范化培訓住院醫師、醫學生及神經內科、急診科臨床醫師，第一組共18例，第二組共19例。第一組學員采用良性陣發性位置性眩暈傳統教學模式，第二組學員采用新教學模式學習，通過學員自評表調查教學效果，并進行比較。 結果 兩組學員分別采用不同教學模式后對良性陣發性位置性眩暈診斷和復位手法掌握的熟練程度對比差異有統計學意義（P<0.05）。第一組學員學習后的熟練程度以不大熟練所占比重最大，第二組學員學習后的熟練程度以熟練所占比重最大。 結論 基于標準空間半規管模型進行良性陣發性位置性眩暈教學可以有效達到教學目標。

[關鍵詞] 半規管；眩暈；模型；教學

[中圖分類號] R4 [文獻標識碼] B [文章編號] 1673-9701（2017）13-0135-04

[Abstract] Objective To explore the application of a new teaching mode combined with traditional teaching mode with standard space semi-circular canal model animation demonstration and 3D print model in benign paroxysmal positional vertigo teaching. Methods The teaching subjects were the resident physicians， medical students， clinicians from Neurology Department and Emergency Department who received standardized training of rotation residency in September 2016 and October 2016 respectively， and they were divided into two groups， 18 subjects for group 1 and 19 subjects for group 2. The subjects of group 1 were given traditional teaching mode of benign paroxysmal positional vertigo， and the subjects of group 2 were given new teaching mode， and the teaching effects were investigated with the student self-evaluation form and compared. Results After receiving different teaching mode， the subjects of both groups showed statistically significant difference in the proficiency of benign paroxysmal positional vertigo diagnosis and manipulative reduction（P<0.05）. The large proportion of subjects of group 1 showed low proficiency， while large proportion of subjects of group 2 showed high proficiency. Conclusion Benign paroxysmal positional vertigo teaching based on standard space semicircular canal model can achieve teaching objective.

[Key words] Semicircular canal； Vertigo； Model； Teaching

良性陣發性位置性眩暈（benign paroxysmal positional vertigo，BPPV）又稱耳石癥，是當特定頭位改變時出現的陣發性短暫性眩暈，目前認為是最為常見的周圍性前庭系統疾病[1-4]，占周圍性眩暈的20%～30%[5]。BPPV發病年齡多集中于中老年，女性發病率高于男性[6]。BPPV最常見的類型是后半規管BPPV，約占60%～90%[7，8]，其次是水平半規管BPPV，占5%～15%[9]，最為少見的是前半規管BPPV，約占1%～3%[8-10]。此病可自愈，有研究顯示，患者從首次發病到自發緩解的平均時間：水平半規管BPPV為7 d，后半規管BPPV為17 d[11]，但其自愈的時間有時可達數月甚至數年。該病發作時患者較痛苦，可伴惡心嘔吐、大汗淋漓等自主神經興奮癥狀，導致患者不敢轉頭翻身起床，嚴重者可使患者喪失工作能力，并嚴重影響其生活質量，故應在門診就診時盡快識別，并給予有效治療。……