Kudzidza mashandisirwo emusanganiswa weiyo 3D imaging tekinoroji uye ine dambudziko-yakavakirwa modhi yekudzidza mukudzidziswa kwekiriniki ine chekuita nekuvhiya musana.
Pakazara, vadzidzi ve106 vekosi yemakore mashanu yekudzidza mune yakakosha "Clinical Medicine" vakasarudzwa sezvidzidzo zvechidzidzo ichi, avo muna 2021 vachange vaine internship mudhipatimendi remapfupa pachipatara chakabatana cheXuzhou Medical University.Vadzidzi ava vakapatsanurwa zvisina tsarukano kuita mapoka ekuyedza nekudzora, aine vadzidzi makumi mashanu nevatatu muboka rega rega.Boka rekuyedza rakashandisa musanganiswa weiyo 3D imaging tekinoroji uye yePBL yekudzidza modhi, nepo boka rekutonga richishandisa nzira yekudzidza yechinyakare.Mushure mekudzidziswa, kubudirira kwekudzidziswa mumapoka maviri aya kwakafananidzwa uchishandisa bvunzo uye mibvunzo.
Nhamba yose pamuedzo wezvidzidzo zvevadzidzi veboka rekuedza yakanga yakakwirira kudarika yevadzidzi veboka rekutonga.Vadzidzi vemapoka maviri aya vakazvimiririra vakaongorora mamakisi avo muchidzidzo, nepo mamakisi evadzidzi veboka rekuyedza aive akakwira kupfuura evadzidzi veboka rekutonga (P <0.05).Kufarira mukudzidza, mamiriro ekirasi, kudyidzana mukirasi, uye kugutsikana nekudzidzisa kwaive kwakakwira pakati pevadzidzi muboka rekuyedza kupfuura muboka rekutonga (P <0.05).
Iko kusanganiswa kwe 3D imaging tekinoroji uye PBL yekudzidza modhi pakudzidzisa kuvhiyiwa kwemusana kunogona kusimudzira kugona kwekudzidza uye kufarira kwevadzidzi, uye kukurudzira kuvandudzwa kwekufunga kwevadzidzi kwekiriniki.
Mumakore achangopfuura, nekuda kwekuenderera mberi kwekuunganidza ruzivo rwekiriniki uye tekinoroji, mubvunzo werudzii rwedzidzo yezvokurapa inogona kunyatso kudzikisa nguva inotora kubva kuvadzidzi vezvokurapa kuenda kune vanachiremba uye nekukurumidza kukura vagari vakanaka yave nyaya yekunetsa.yakakwezva vanhu vazhinji [1].Kudzidzira kwekiriniki idanho rakakosha mukusimudzira kufunga kwekiriniki uye kugona kwevadzidzi vekurapa.Kunyanya, kuvhiya kunoisa zvinodiwa zvakasimba pane hunoshanda kugona kwevadzidzi uye ruzivo rwemuviri wemunhu.
Parizvino, tsika yechinyakare yekudzidzisa ichiri kutonga muzvikoro nemushonga wekiriniki [2].Nzira yekudzidzisa yechinyakare inonangana nemudzidzisi: mudzidzisi anomira pachikuva uye achiendesa ruzivo kuvadzidzi kuburikidza nenzira dzechinyakare dzekudzidzisa dzakaita semabhuku uye multimedia curricula.Kosi yese inodzidziswa nemudzidzisi.Vadzidzi vanowanzo teerera kuhurukuro, mikana yehurukuro yemahara uye mibvunzo ishoma.Nekuda kweizvozvo, maitiro aya anogona kushandura zviri nyore kuita kune rimwe divi indoctrination kudivi revadzidzisi nepo vadzidzi vachingogamuchira mamiriro acho ezvinhu.Nokudaro, mumuitiro wokudzidzisa, vadzidzisi vanowanzowana kuti fariro yavadzidzi yokudzidza haina kukwirira, fariro yacho haina kukwirira, uye muuyo wacho wakashata.Mukuwedzera, zvakaoma kutsanangura zvakajeka chimiro chakaoma chemuzongoza uchishandisa 2D mifananidzo yakadai sePPT, mabhuku ezvinyorwa zveanatomy nemifananidzo, uye hazvisi nyore kuti vadzidzi vanzwisise uye vagone ruzivo urwu [3].
Muna 1969, nzira itsva yekudzidzisa, yekudzidza-dambudziko (PBL), yakaedzwa paMcMaster University School of Medicine muCanada.Kusiyana nenzira dzechinyakare dzekudzidzisa, chirongwa chePBL chekudzidza chinobata vadzidzi sechikamu chakakosha chemaitiro ekudzidza uye chinoshandisa mibvunzo yakakodzera sekurudziro kuti vadzidzi vagone kudzidza, kukurukura nekubatana vakazvimiririra mumapoka, vachishingaira kubvunza mibvunzo uye kuwana mhinduro pane kungozvigamuchira., 5].Mukuita kuongorora nekugadzirisa matambudziko, gadzira kugona kwevadzidzi pakudzidza vakazvimiririra uye kufunga zvine musoro [6].Pamusoro pezvo, nekuda kwekuvandudzwa kwehunyanzvi hwekurapa hwedhijitari, nzira dzekudzidzisa dzekiriniki dzakapfumiswawo zvakanyanya.3D imaging tekinoroji (3DV) inotora data mbishi kubva kumifananidzo yekurapa, yoipinza mumodelling software ye 3D kuvaka patsva, uye yobva yagadzirisa data kugadzira 3D modhi.Iyi nzira inokunda ganhuriro dzechinyakare dzidziso modhi, inounganidza kutarisisa kwevadzidzi munzira dzakawanda uye inobatsira vadzidzi nekukurumidza kugona maumbirwo akaomarara eanatomical [7, 8], kunyanya mudzidzo yemapfupa.Naizvozvo, chinyorwa ichi chinosanganisa nzira mbiri idzi dzekudzidza mhedzisiro yekubatanidza PBL ne 3DV tekinoroji uye yechinyakare yekudzidza maitiro mune inoshanda application.Mhedzisiro yacho inotevera.
Chinangwa chechidzidzo chacho chaiva chevadzidzi ve106 vakapinda muhutano hwekuvhiyiwa kwechipatara chechipatara chedu muna 2021, avo vakakamurwa kuva mapoka ekuedza uye ekudzora vachishandisa tafura yenhamba, vadzidzi ve53 muboka rimwe nerimwe.Boka rekuedza raive nevarume ve25 uye vakadzi ve28 vane makore 21 kusvika kumakore 23, kureva makore 22.6± 0.8 makore.Boka rekutonga raisanganisira varume makumi maviri nevaviri nevakadzi makumi maviri nevanomwe vane makore 21-24, avhareji yezera 22.6± 0.9 makore, vadzidzi vese vadzidzisi.Pakanga pasina musiyano wakakosha muzera uye murume kana mukadzi pakati pemapoka maviri aya (P> 0.05).
Maitiro ekuisirwa ndeaya anotevera: (1) Yechina-yegore yakazara-yenguva yakazara yekiriniki bachelor vadzidzi;(2) Vadzidzi vanogona kutaura zvakajeka manzwiro avo echokwadi;(3) Vadzidzi vanogona kunzwisisa uye nekuzvidira kutora chikamu muhurongwa hwese hwechidzidzo ichi uye kusaina fomu remvumo vane ruzivo.Mamiriro ekubvisa ndeaya anotevera: (1) Vadzidzi vasingasangane nechero nzira yekubatanidzwa;(2) Vadzidzi vasingade kutora chikamu mukudzidziswa uku nekuda kwezvikonzero zvavo;(3) Vadzidzi vane ruzivo rwekudzidzisa rwePBL.
Ngenisa mbishi CT data musimulation software uye pinza iyo yakavakirwa modhi mune yakasarudzika kudzidzisa software yekuratidzira.Muenzaniso unosanganisira mapfupa emapfupa, intervertebral discs uye spinal nerves (Fig. 1).Zvikamu zvakasiyana zvinomiririrwa nemavara akasiyana, uye muenzaniso unogona kuwedzerwa uye kutenderedzwa sezvaunoda.Kubatsira kukuru kwechirongwa ichi ndechekuti CT layers inogona kuiswa pamuenzaniso uye kujeka kwezvikamu zvakasiyana zvinogona kugadziridzwa kuti zvinyatso kudzivirira kuvharika.
a Rear view uye b Side view.muL1, L3 uye pelvis yemuenzaniso iri pachena.d Mushure mekubatanidza CT cross-section image nemuenzaniso, unogona kuifambisa kumusoro uye pasi kuti ugadzire ndege dzeCT dzakasiyana.e Yakasanganiswa modhi yesagittal CT mifananidzo uye kushandiswa kwemirayiridzo yakavanzika yekugadzirisa L1 uye L3
Nyaya huru yekudzidziswa ndeyotevera: 1) Kuongororwa uye kurapwa kwezvirwere zvakajairika mukuvhiyiwa kwepelinha;2) Kuziva kweanatomy yemuzongoza, kufunga uye kunzwisisa kwekuitika uye kukura kwezvirwere;3) Mavhidhiyo ekushanda achidzidzisa ruzivo rwekutanga.Matanho ekuvhiyiwa kwepelinha, 4) Kuonekwa kwezvirwere zvinowanzoitika mukuvhiyiwa kwemusana, 5) Classical theoretical knowledge yekuyeuka, kusanganisira dzidziso yeDennis 'matatu-column spine, kupatsanurwa kwepelinha fractures, uye kupatsanurwa kweherniated lumbar spine.
Boka rekuedza: Nzira yekudzidzisa inosanganiswa nePBL uye 3D imaging tekinoroji.Iyi nzira inosanganisira zvinhu zvinotevera.1) Kugadzirira kwezviitiko zvinowanzoitika mukuvhiyiwa kwemusana: Kurukurai nyaya dzekervical spondylosis, lumbar disc herniation, uye pyramidal compression fractures, uye nyaya imwe neimwe inotarisa pane zvakasiyana-siyana zvezivo.Mhosva, 3D modhi uye mavhidhiyo ekuvhiya anotumirwa kuvadzidzi svondo pamberi pekirasi uye vanokurudzirwa kushandisa iyo 3D modhi kuyedza ruzivo rweanatomical.2) Kufanogadzirira: Maminitsi gumi pamberi pekirasi, suma vadzidzi kune chaiyo PBL yekudzidza maitiro, kurudzira vadzidzi kutora chikamu zvine hungwaru, kushandisa zvizere nguva, uye kupedza migove nehungwaru.Kuita mapoka kwakaitwa mushure mekuwana mvumo yevatori vechikamu vose.Tora vadzidzi 8 kusvika gumi vari muboka, pindana mumapoka akasununguka kufunga nezveruzivo rwekutsvaga nyaya, funga nezvekuzvinzvera, kutora chikamu munhaurirano dzeboka, pindurana, pakupedzisira pfupikisa pfungwa huru, gadzira data rakarongeka, uye nyora nhaurirano.Sarudza mudzidzi ane hunyanzvi hwakasimba hwekuronga uye hwekutaura semutungamiri weboka kuronga nhaurirano dzeboka nemharidzo.3) Mudzidzisi Nhungamiro: Vadzidzisi vanoshandisa software yekufananidza kutsanangura anatomy yemuzongoza mukubatana neyakajairwa kesi, uye bvumidza vadzidzi kuti vashandise zvine mutsindo software kuita maoparesheni akadai sekudhonza, kutenderera, kudzorerazve CT uye kugadzirisa kujeka kwetishu;Kuve nekunzwisisa kwakadzama uye nemusoro kwechimiro chechirwere, uye kuvabatsira kuti vafunge vakazvimirira pamusoro pezvisungo zvakakura mukutanga, kukura uye nzira yechirwere.4) Kuchinjana kwemaonero uye nhaurirano.Mukupindura mibvunzo yakanyorwa pamberi pekirasi, ipa hurukuro dzehurukuro dzekirasi uye koka mutungamiri weboka wega wega kuti ataure pamusoro pezvabuda munhaurirano yeboka mushure menguva yakakwana yehurukuro.Panguva iyi, boka rinogona kubvunzana mibvunzo nekubatsirana, ukuwo mudzidzisi achifanira kunyatsonyora nekunzwisisa mafungiro evadzidzi uye matambudziko ane chekuita navo.5) Pfupiso: Mushure mekukurukura nevadzidzi, mudzidzisi anozotaura pamusoro pekuita kwevadzidzi, kupfupikisa uye kupindura zvakadzama mimwe mibvunzo inowanzoitika uye ine gakava, uye kuburitsa gwara rekudzidza kweramangwana kuitira kuti vadzidzi vagone kuenderana nenzira yekudzidzisa yePBL.
Boka rinodzora rinoshandisa nzira yekudzidza yechinyakare, kuraira vadzidzi kuti vatarise zvigadzirwa pamberi pekirasi.Kuitisa zvidzidzo zvedzidziso, vadzidzisi vanoshandisa mabhodhi machena, multimedia curricula, mavhidhiyo zvinhu, mienzaniso yemuenzaniso uye zvimwe zvinobatsira zvekudzidzisa, uye zvakare kuronga kosi yekudzidziswa zvinoenderana nemidziyo yekudzidzisa.Sewedzero kukharikhulamu, iyi nhanho inotarisana nematambudziko akakodzera uye pfungwa dzakakosha dzebhuku.Pashure pehurukuro, mudzidzisi akapfupikisa mashoko acho ndokukurudzira vadzidzi kurangarira nomusoro uye kunzwisisa ruzivo rwakakodzera.
Maererano nezviri mukudzidziswa, bvunzo yebhuku yakavharwa yakagamuchirwa.Mibvunzo yechinangwa inosarudzwa kubva kumibvunzo yakakodzera inobvunzwa nevarapi mumakore apfuura.Mibvunzo ine musoro inogadzirwa neDhipatimendi reOrthopedics uye pakupedzisira inoongororwa nenhengo dzefekisheni dzisingatore bvunzo.Tora chikamu mukudzidza.Mucherechedzo uzere webvunzo zvibodzwa zana, uye zvirimo zvinonyanya zvinosanganisira zvikamu zviviri zvinotevera: 1) Mibvunzo yezvinangwa (kunyanya mibvunzo yesarudzo), iyo inonyanya kuyedza kugona kwevadzidzi zvinhu zveruzivo, inova 50% yezvibodzwa zvese. ;2) Mibvunzo yenyaya (mibvunzo yekuongorora nyaya), kunyanya yakanangana nekunzwisisa kwakarongeka uye kuongororwa kwezvirwere nevadzidzi, inova 50% yezvibodzwa zvese.
Pakupera kwekosi yacho, mibvunzo ine zvikamu zviviri nemibvunzo mipfumbamwe yakapiwa.Zvikuru zviri mumibvunzo iyi zvinoenderana nezvinhu zviri mutafura, uye vadzidzi vanofanira kupindura mibvunzo iri pazvinhu izvi vaine mamaki akazara ezvibodzwa gumi uye chibodzwa che1.Zvibodzwa zvepamusoro zvinoratidza kugutsikana kwemudzidzi.Mibvunzo iri muTable 2 iri pamusoro pekuti musanganiswa wePBL ne3DV modhi yekudzidza ungabatsira vadzidzi kunzwisisa ruzivo rwehunyanzvi rwakaoma.Tafura 3 zvinhu zvinoratidza kugutsikana kwevadzidzi nemhando mbiri dzekudzidza.
Yese data yakaongororwa uchishandisa SPSS 25 software;mhinduro dzebvunzo dzakaratidzwa sezvinoreva ± zvakajairwa kutsauka (x ± s).Nhamba yedata yakaongororwa neimwe-nzira ANOVA, data yemhando yakaongororwa ne χ2 bvunzo, uye kururamisa kwaBonferroni kwakashandiswa pakuenzanisa kwakawanda.Musiyano unokosha (P <0.05).
Migumisiro yenhamba yekuongorora yemapoka maviri yakaratidza kuti zvibodzwa pamibvunzo yechinangwa (mibvunzo yakawanda yesarudzo) yevadzidzi veboka rekutonga zvaive zvakanyanya kudarika zvevadzidzi veboka rekuedza (P <0.05), uye zvibodzwa. yevadzidzi veboka rekutonga vakanga vakakwirira zvikuru, kupfuura vadzidzi veboka rekuedza (P <0.05).Zviverengero zvemibvunzo yekuzvimiririra (mibvunzo yekuongorora nyaya) yevadzidzi veboka rekuyedza yaive yakakwira zvakanyanya kupfuura yevadzidzi veboka rekutonga (P <0.01), ona Tafura.1.
Mapepa emibvunzo asingazivikanwi akagoverwa pashure pemakirasi ose.Pakazara, 106 mibvunzo yakagoverwa, 106 yadzo yakadzorerwa, nepo chiyero chekudzorera chaive 100.0%.Mafomu ose akazadzwa.Kuenzaniswa kwezvakabuda muongororo yemibvunzo pamusoro pehuwandu hwekuva neruzivo rwehunyanzvi pakati pemapoka maviri evadzidzi kwakaratidza kuti vadzidzi veboka rekuyedza vanokwanisa matanho makuru ekuvhiya musana, ruzivo rwehurongwa, kupatsanurwa kwezvirwere zvechinyakare, nezvimwe. .Musiyano wacho waive wakakosha (P <0.05) sezvakaratidzwa muTable 2.
Kuenzaniswa kwemhinduro kumibvunzo ine chekuita nekugutsikana kwekudzidzisa pakati pemapoka maviri: vadzidzi vari muboka rekuedza vakawana zvakapfuura vadzidzi vari muboka rekutonga maererano nekufarira kudzidza, mhepo yemukirasi, kusangana mukirasi, uye kugutsikana nedzidziso.Musiyano wacho waive wakakosha (P <0.05).Tsanangudzo inoratidzwa muTafura 3.
Nekuenderera mberi kwekuunganidza nekuvandudzwa kwesainzi uye tekinoroji, kunyanya sezvatinopinda muzana ramakore rechi21, basa rekiriniki muzvipatara riri kuramba richiwedzera kuoma.Kuitira kuona kuti vadzidzi vezvokurapa vanokwanisa kukurumidza kujairana nebasa rekiriniki uye kukudziridza matarenda ekurapa emhando yepamusoro kuitira kubatsira nzanga, kudzidziswa kwechinyakare uye nzira yakabatana yekudzidza vanosangana nematambudziko mukugadzirisa matambudziko anoshanda ekiriniki.Iyo yechinyakare modhi yedzidzo yekurapa munyika yangu ine mabhenefiti ehuwandu hweruzivo mukirasi, yakaderera zvinodiwa kwezvakatipoteredza, uye ruzivo rwedzidziso iyo inogona kuzadzisa zvinodiwa zvekudzidzisa zvidzidzo zvedzidziso [9].Nekudaro, iyi nzira yedzidzo inogona kutungamira nyore kune mukaha pakati pedzidziso nekuita, kudzikira kwekutanga uye kufarira kwevadzidzi mukudzidza, kusakwanisa kunyatsoongorora zvirwere zvakaoma mukurapa kwekiriniki uye, nekudaro, haigone kuzadzisa zvinodiwa zvekurapa kwepamusoro. dzidzo.Mumakore achangopfuura, chiyero chekuvhiya musana munyika yangu chakawedzera nekukurumidza, uye dzidziso yekuvhiya musana yakatarisana nematambudziko matsva.Munguva yekudzidziswa kwevadzidzi vezvokurapa, chikamu chakaoma chekuvhiya ndeye orthopedics, kunyanya kuvhiyiwa kwemusana.Mapoinzi eruzivo haadiki uye ane hanya kwete chete musana urema uye hutachiona, asiwo kukuvara uye mapfupa emamota.Aya mazano haasi ega uye akaoma kunzwisisa, asi zvakare ane hukama zvakanyanya neanatomy, pathology, imaging, biomechanics, uye mamwe maitiro, zvichiita kuti zvirimo zviome kunzwisisa nekurangarira.Panguva imwecheteyo, nzvimbo dzakawanda dzekuvhiyiwa kwepelinha dziri kukura nokukurumidza, uye ruzivo rwuri mumabhuku ekare aripo rwakasakara, izvo zvinoita kuti zvive zvakaoma kuvadzidzisi kudzidzisa.Nekudaro, kushandura nzira yekudzidzisa yechinyakare uye kubatanidza zvichangobva kuitika mukutsvagisa kwenyika kunogona kuita kuti dzidziso yeruzivo rwakakodzera rwedzidziso ishande, kuvandudza kugona kwevadzidzi kufunga zvine musoro, uye kukurudzira vadzidzi kufunga zvakadzama.Izvi zvinokanganisa pazvinoitwa pakudzidza zvinofanirwa kugadziriswa nekuchimbidza kuitira kuongorora miganhu nemiganhu yeruzivo rwemazuva ano rwekurapa uye kukunda zvipingamupinyi zvechinyakare [10].
Iyo PBL yekudzidza modhi inzira yekudzidza yakanangana nemudzidzi.Kuburikidza nekudzidza kwakadzama, kwakazvimirira uye nhaurirano yekudyidzana, vadzidzi vanogona kuburitsa manyawi zvizere vobva pakugashira ruzivo vachipinda mukuita zvechimbichimbi mukudzidzisa kwemudzidzisi.Zvichienzaniswa nedzidzo-yakavakirwa pakudzidza modhi, vadzidzi vari kutora chikamu muPBL yekudzidza modhi vane nguva yakakwana yekushandisa zvinyorwa, Indaneti, uye software kutsvaga mhinduro dzemibvunzo, kufunga vakazvimiririra, uye kukurukura nyaya dzinechekuita munharaunda yeboka.Iyi nzira inovandudza kugona kwevadzidzi kufunga vakazvimirira, kuongorora matambudziko uye kugadzirisa matambudziko [11].Mukuita hurukuro yemahara, vadzidzi vakasiyana vanogona kuve nemazano akawanda akasiyana nezvenyaya imwe chete, izvo zvinopa vadzidzi chikuva chekuwedzera kufunga kwavo.Gadzira kufunga kwekusika uye kugona kufunga zvine musoro kuburikidza nekuenderera mberi kwekufunga, uye kuvandudza kugona kutaura kwemuromo uye mweya wechikwata kuburikidza nekutaurirana pakati pevaunodzidza navo [12].Kunyanya kukosha, kudzidzisa PBL kunobvumira vadzidzi kuti vanzwisise nzira yekuongorora, kuronga nekushandisa ruzivo rwakakodzera, kugona nzira dzekudzidzisa dzakakodzera uye kuvandudza kugona kwavo kwakazara [13].Munguva yekudzidza kwedu, takaona kuti vadzidzi vainyanya kufarira kudzidza kushandisa 3D imaging software pane kunzwisisa zvinofinha zvehunyanzvi zvekurapa kubva mumabhuku, saka mukudzidza kwedu, vadzidzi vari muboka rekuyedza vanowanzokuchidzirwa zvakanyanya kutora chikamu mukudzidza. process.zviri nani pane boka rekutonga.Vadzidzisi vanofanira kukurudzira vadzidzi kuti vataure vakashinga, kukudziridza ruzivo rwechidzidzo chemudzidzi, uye kukurudzira kufarira kwavo kutora chikamu munhaurirano.Mhedzisiro dzebvunzo dzinoratidza kuti, maererano neruzivo rwemechanical memory, kuita kwevadzidzi muboka rekuyedza kwakadzikira pane kweboka rekutonga, zvisinei, pakuongororwa kwechiitiko chekiriniki, chinoda kushandiswa kwakaoma kweruzivo rwakakodzera, kushanda kwevadzidzi muboka rekuedza kuri nani kupfuura muboka rekutonga, iro rinosimbisa hukama pakati pe3DV neboka rekutonga.Zvakanakira kubatanidza mishonga yechivanhu.Iyo PBL nzira yekudzidzisa ine chinangwa chekuvandudza kugona-kutenderera kwevadzidzi.
Dzidziso yeanatomy iri pakati pedzidziso yekiriniki yekuvhiya musana.Nekuda kwechimiro chakaoma chemuzongoza uye chokwadi chekuti kuvhiyiwa kunosanganisira matishu akakosha senge musana, musana wetsinga, uye tsinga dzeropa, vadzidzi vanofanirwa kuve nekufungidzira kwenzvimbo kuti vadzidze.Kare, vadzidzi vaishandisa mifananidzo ine mativi maviri akadai semifananidzo yemabhuku nemifananidzo yemavhidhiyo kutsanangura ruzivo rwakakodzera, asi kunyangwe huwandu uhu hwezvinhu, vadzidzi vaive vasina intuitive uye matatu-dimensional pfungwa mune ichi chinhu, izvo zvakakonzera kuoma mukunzwisisa.Tichifunga nezvemaitiro akaomarara emuzongoza uye epathological maitiro emuzongoza, sehukama pakati pepinal nerves uye vertebral body segments, kune dzimwe pfungwa dzakakosha uye dzakaoma, senge chimiro uye kurongeka kwekervical vertebral fractures.Vadzidzi vazhinji vakashuma kuti zvinyorwa zvekuvhiyiwa kwemuzongoza zvinenge zvisinganzwisisike, uye havagoni kuzvinzwisisa zvakakwana panguva yezvidzidzo zvavo, uye ruzivo rwakadzidza runokanganwa nokukurumidza mushure mekirasi, izvo zvinotungamirira kumatambudziko mubasa chairo.
Achishandisa tekinoroji yekuona 3D, munyori anopa vadzidzi mifananidzo yakajeka ye3D, zvikamu zvakasiyana zvinomiririrwa nemavara akasiyana.Kutenda kumabasa akadai sekutenderera, kuyera uye kujeka, iyo musana muenzaniso uye CT mifananidzo inogona kutariswa muzvikamu.Haisi chete iyo iyo anatomical maficha eiyo vertebral body inonyatso kucherechedzwa, asi zvakare inomutsa chishuwo chevadzidzi kuti vawane inofinha CT mufananidzo wemusana.uye kuwedzera kusimbisa ruzivo mumunda wekuona.Kusiyana nemamodheru uye maturusi ekudzidzisa aishandiswa kare, basa rakajeka rekugadzirisa rinogona kugadzirisa dambudziko rekuvhara, uye zviri nyore kuti vadzidzi vatarise chimiro cheanatomical yakanaka uye yakaoma nerve kutungamira, kunyanya kune vanotanga.Vadzidzi vanogona kushanda vakasununguka chero vachiuya nemakomputa avo, uye hapana kana mari inobatanidzwa.Iyi nzira inzvimbo yakanaka yekutsiva yechinyakare kudzidziswa uchishandisa 2D mifananidzo [14].Muchidzidzo ichi, boka rekutonga rakaita zviri nani pamibvunzo yechinangwa, zvichiratidza kuti muenzaniso wekudzidzisa wehurukuro haugone kurambwa zvachose uye uchiri nehumwe kukosha mudzidziso yekiriniki yekuvhiya musana.Kuwanikwa uku kwaita kuti tifunge kana tobatanidza maitiro echinyakare ekudzidza nePBL modhi yekudzidza yakavandudzwa nehunyanzvi hwekuona 3D, tichinangana nemhando dzakasiyana dzebvunzo uye vadzidzi vemazinga akasiyana, kuitira kuti dzidzo iwedzere.Nekudaro, hazvina kujeka kuti uye sei nzira mbiri idzi dzinogona kubatanidzwa uye kana vadzidzi vachizogamuchira musanganiswa wakadaro, unogona kuve gwara rekutsvaga mune ramangwana.Chidzidzo ichi chinotarisanawo nezvimwe zvipingamupinyi zvakaita sekurerekera kunobvira kana vadzidzi vapedza mubvunzo mushure mekuona kuti vachange vachitora chikamu mumuenzaniso mutsva wedzidzo.Ichi chidzidzo chekudzidzisa chinoshandiswa chete mumamiriro ekuvhiyiwa kwemusana uye kuwedzera kuongororwa kunodiwa kana kuchigona kushandiswa pakudzidzisa kwemaitiro ose ekuvhiya.
Isu tinosanganisa tekinoroji yekufungidzira ye3D neiyo PBL yekudzidzisa modhi, kukurira zvipingamupinyi zvechinyakare maitiro ekudzidzira uye maturusi ekudzidzisa, uye kudzidza kushanda kunoshanda kwemusanganiswa uyu mukudzidziswa kwekiriniki yekuyedza mukuvhiya musana.Tichitarisa nemhedzisiro yebvunzo, mhedzisiro yebvunzo yevadzidzi veboka rekuyedza iri nani pane yevadzidzi veboka rekutonga (P <0.05), uye ruzivo rwehunyanzvi uye kugutsikana nezvidzidzo zvevadzidzi veboka rekuyedza. zvakare vari nani pane avo vevadzidzi veboka rekuyedza.boka rekutonga (P <0.05).Mhedzisiro yemubvunzo webvunzo yaive nani pane iyo yeboka rekutonga (P <0.05).Nekudaro, zviedzo zvedu zvinosimbisa kuti kusanganiswa kwePBL ne3DV matekinoroji kunobatsira mukugonesa vadzidzi kushandisa pfungwa dzekiriniki, kuwana ruzivo rwehunyanzvi, uye kuwedzera kufarira kwavo kudzidza.
Iko kusanganiswa kwePBL ne3DV matekinoroji kunogona kuvandudza zvinobudirira mashandiro ekiriniki yevadzidzi vezvokurapa mumunda wekuvhiya musana, kuwedzera kugona kwekudzidza uye kufarira kwevadzidzi, uye kubatsira kukudziridza kufunga kwevadzidzi kwekiriniki.3D imaging tekinoroji ine zvakakosha zvakakosha mukudzidzisa anatomy, uye iyo yese dzidziso mhedzisiro iri nani pane yechinyakare maitiro ekudzidzisa.
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Dhipatimendi Rokuvhiya Muzongoza, Xuzhou Medical University Branch Hospital, Xuzhou, Jiangsu, 221006, China
Vese vanyori vakapa pfungwa uye magadzirirwo echidzidzo.Kugadzirira kwezvinhu, kuunganidza data uye kuongororwa kwakaitwa naSun Maji, Chu Fuchao uye Feng Yuan.Kunyorwa kwekutanga kwechinyorwa chakanyorwa naChunjiu Gao, uye vanyori vese vakataura nezveshanduro dzakapfuura dzechinyorwa.Vanyori vakaverenga uye vakabvumira chinyorwa chekupedzisira.
Ichi chidzidzo chakatenderwa neXuzhou Medical University Affiliated Hospital Ethics Committee (XYFY2017-JS029-01).Vose vatori vechikamu vakapa mvumo yekuziva vasati vadzidza, zvidzidzo zvose zvaive vanhu vakuru vane hutano, uye chidzidzo chacho hachina kuputsa Declaration of Helsinki.Ita shuwa kuti nzira dzese dzinoitwa zvinoenderana negwara rakakodzera uye mirau.
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Sun Ming, Chu Fang, Gao Cheng, et al.3D imaging yakasanganiswa nedambudziko-based kudzidza modhi mukudzidzisa kuvhiya musana BMC Medical Dzidzo 22, 840 (2022).https://doi.org/10.1186/s12909-022-03931-5
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