Samfuran tsarin jiki masu girma uku (3DPAMs) sun zama kayan aiki masu dacewa saboda ƙimar iliminsu da yuwuwarsu. Manufar wannan bita ita ce bayyana da kuma nazarin hanyoyin da ake amfani da su don ƙirƙirar 3DPAM don koyar da tsarin jikin ɗan adam da kuma kimanta gudummawarsa ta hanyar koyarwa.
An gudanar da bincike ta hanyar lantarki a PubMed ta amfani da waɗannan kalmomi: ilimi, makaranta, koyo, koyarwa, horo, koyarwa, ilimi, girma uku, 3D, girma uku, bugu, bugu, bugu, jiki, jiki, jiki, da jiki. Abubuwan da aka gano sun haɗa da halayen karatu, ƙirar samfuri, kimanta yanayin jiki, aikin ilimi, ƙarfi da rauni.
Daga cikin labaran da aka zaɓa guda 68, mafi yawan binciken da aka mayar da hankali kan yankin kwanyar (labarai 33); labarai 51 sun ambaci bugun ƙashi. A cikin labarai 47, an ƙirƙiri 3DPAM bisa ga lissafin tomography. An lissafa hanyoyin bugawa guda biyar. An yi amfani da robobi da abubuwan da suka samo asali a cikin bincike 48. Kowane ƙira yana farawa daga $1.25 zuwa $2,800. Nazarin talatin da bakwai ya kwatanta 3DPAM da samfuran tunani. Labarai talatin da uku sun binciki ayyukan ilimi. Manyan fa'idodin sune ingancin gani da taɓawa, ingancin koyo, maimaitawa, daidaitawa da sauri, adana lokaci, haɗakar aikin jiki, ingantaccen ikon juyawar tunani, riƙe ilimi da gamsuwar malami/ɗalibi. Babban rashin amfanin yana da alaƙa da ƙira: daidaito, rashin cikakkun bayanai ko bayyananne, launuka masu haske sosai, lokutan bugawa masu tsayi da tsada mai yawa.
Wannan bita mai tsari ya nuna cewa 3DPAM yana da inganci kuma yana da tasiri wajen koyar da ilimin halittar jiki. Ƙarin samfuran gaskiya suna buƙatar amfani da fasahar buga 3D mafi tsada da kuma tsawon lokacin ƙira, wanda zai ƙara yawan kuɗin gaba ɗaya. Mabuɗin shine zaɓar hanyar daukar hoto da ta dace. Daga mahangar koyarwa, 3DPAM kayan aiki ne mai tasiri don koyar da ilimin halittar jiki, tare da tasiri mai kyau akan sakamakon koyo da gamsuwa. Tasirin koyarwa na 3DPAM ya fi kyau lokacin da ya sake haifar da yankuna masu rikitarwa na ilimin halittar jiki kuma ɗalibai suna amfani da shi da wuri a cikin horon likitanci.
An yi rarraba gawarwakin dabbobi tun zamanin Girka kuma yana ɗaya daga cikin manyan hanyoyin koyar da ilimin halittar jiki. Ana amfani da rarraba gawarwakin da aka yi a lokacin horo na aiki a cikin manhajar nazarin ilmin halittar jiki na ɗaliban jami'a kuma a halin yanzu ana ɗaukar su a matsayin ma'aunin zinare don nazarin ilimin halittar jiki [1,2,3,4,5]. Duk da haka, akwai cikas da yawa ga amfani da samfuran gawarwakin mutane, wanda hakan ke haifar da neman sabbin kayan aikin horo [6, 7]. Wasu daga cikin waɗannan sabbin kayan aikin sun haɗa da gaskiyar da aka ƙara, kayan aikin dijital, da bugu na 3D. A cewar wani bita na wallafe-wallafen da Santos et al. [8] ya yi kwanan nan game da ƙimar waɗannan sabbin fasahohi don koyar da ilimin halittar jiki, bugawa na 3D ya zama ɗaya daga cikin mahimman albarkatu, duka dangane da ƙimar ilimi ga ɗalibai da kuma dangane da yuwuwar aiwatarwa [4,9,10].
Buga 3D ba sabon abu bane. Haƙƙin mallaka na farko da suka shafi wannan fasaha ya samo asali ne tun daga shekarar 1984: A Le Méhauté, O De Witte da JC André a Faransa, kuma bayan makonni uku C Hull a Amurka. Tun daga lokacin, fasahar ta ci gaba da bunƙasa kuma amfaninta ya faɗaɗa zuwa wurare da yawa. Misali, NASA ta buga abu na farko bayan Duniya a shekarar 2014 [11]. Bangaren likitanci ya kuma yi amfani da wannan sabon kayan aiki, wanda hakan ya ƙara sha'awar haɓaka magani na musamman [12].
Marubuta da yawa sun nuna fa'idodin amfani da samfuran jiki na 3D (3DPAM) a cikin ilimin likitanci [10, 13, 14, 15, 16, 17, 18, 19]. Lokacin koyar da ilimin jikin ɗan adam, ana buƙatar samfuran da ba na cututtuka ba da kuma waɗanda suka dace da yanayin jiki. Wasu sake dubawa sun bincika samfuran horo na ilimin cututtuka ko na likita/tiyata [8, 20, 21]. Don haɓaka samfurin haɗin gwiwa don koyar da ilimin jikin ɗan adam wanda ya haɗa da sabbin kayan aiki kamar bugawa ta 3D, mun gudanar da bita mai tsari don bayyana da kuma nazarin yadda ake ƙirƙirar abubuwan da aka buga ta 3D don koyar da ilimin jikin ɗan adam da kuma yadda ɗalibai ke kimanta ingancin koyo ta amfani da waɗannan abubuwan 3D.
An gudanar da wannan bita na wallafe-wallafen tsari a watan Yunin 2022 ba tare da takaita lokaci ba ta amfani da jagororin PRISMA (Abubuwan da aka Fi So don Bita na Tsari da Nazarin Meta) [22].
Sharuɗɗan haɗawa duk takardun bincike ne da ke amfani da 3DPAM a cikin koyarwa/koyo na jiki. An cire bita na adabi, wasiƙu, ko labarai da suka mayar da hankali kan samfuran cututtuka, samfuran dabbobi, samfuran kayan tarihi, da samfuran horo na likita/tiyata. An zaɓi labaran da aka buga a cikin Turanci kawai. An cire labaran da ba su da taƙaitaccen bayani akan layi. An haɗa da labaran da suka haɗa da samfura da yawa, aƙalla ɗaya daga cikinsu al'ada ce ta jiki ko kuma yana da ƙananan cututtukan da ba su shafi darajar koyarwa ba.
An gudanar da binciken adabi a cikin bayanan lantarki na PubMed (National Library of Medicine, NCBI) don gano nazarin da suka dace da aka buga har zuwa Yuni 2022. Yi amfani da waɗannan kalmomin bincike: ilimi, makaranta, koyarwa, koyarwa, koyo, koyarwa, ilimi, girma uku, 3D, 3D, bugu, bugawa, bugu, tsarin jiki, tsarin jiki, tsarin jiki da tsarin jiki. An yi tambaya guda ɗaya: (((ilimi[Take/Take] KO makaranta[Take/Take] KO karatu[Take/Take] KO koyarwa[Take/Take] KO horo[Take/Take] OReach[Take/Take]] KO Ilimi [Take/Take]) DA (Girman Uku [Take] KO 3D [Take] KO 3D [Take])) DA (Buga [Take] KO Buga [Take] KO Buga [Take])) DA (Natural) [Take] ]/take] ko ilmin jikin mutum [take/take] ko ilmin jikin mutum [take/take] ko ilmin jikin mutum [take/take] ko ilmin jikin mutum [take/take]). An gano ƙarin labarai ta hanyar bincika bayanan PubMed da hannu da kuma sake duba nassoshi na wasu labaran kimiyya. Babu wani ƙuntatawa na ranar da aka yi amfani da shi, amma an yi amfani da matattarar "Mutum".
An tantance dukkan taken da aka samo da kuma taƙaitaccen bayani daga marubuta biyu (EBR da AL), kuma an cire duk wani bincike da bai cika dukkan sharuɗɗan cancanta ba. An dawo da cikakkun wallafe-wallafen sauran karatun kuma an sake duba su ta hanyar marubuta uku (EBR, EBE da AL). Idan ya zama dole, mutum na huɗu (LT) ne zai warware rashin jituwa a zaɓen labaran. An haɗa wallafe-wallafen da suka cika dukkan sharuɗɗan haɗawa a cikin wannan bita.
Marubuta biyu (EBR da AL) ne suka gudanar da aikin fitar da bayanai daban-daban a ƙarƙashin kulawar marubuci na uku (LT).
- Bayanan ƙirar samfuri: yankunan jiki, takamaiman sassan jiki, samfurin farko don bugawa na 3D, hanyar siye, rarrabawa da software na ƙira, nau'in firinta na 3D, nau'in kayan aiki da yawa, sikelin bugawa, launi, farashin bugawa.
- Kimanta yanayin halittu na samfura: samfuran da ake amfani da su don kwatantawa, kimantawa ta likita ta ƙwararru/malamai, adadin masu kimantawa, nau'in kimantawa.
- Koyar da samfurin 3D: kimanta ilimin ɗalibai, hanyar tantancewa, adadin ɗalibai, adadin ƙungiyoyin kwatantawa, rarraba ɗalibai bazuwar, ilimi/nau'in ɗalibi.
An gano bincike 418 a cikin MEDLINE, kuma matattarar "ɗan adam" ta cire labarai 139. Bayan duba taken da taƙaitaccen bayani, an zaɓi bincike 103 don karanta cikakken rubutu. An cire labarai 34 saboda ko dai samfuran cututtuka ne (labarai 9), samfuran horo na likita/tiyata (labarai 4), samfuran dabbobi (labarai 4), samfuran rediyo na 3D (labarai 1) ko kuma ba labaran kimiyya na asali ba ne (babi 16). Jimillar labarai 68 an haɗa su a cikin bitar. Hoto na 1 ya gabatar da tsarin zaɓi a matsayin jadawalin kwarara.
Jadawalin kwarara wanda ke taƙaita ganowa, tantancewa, da kuma haɗa labarai a cikin wannan bita mai tsari
An buga dukkan nazarin ne tsakanin 2014 da 2022, tare da matsakaicin shekarar bugawa ta 2019. Daga cikin labaran 68 da aka haɗa, nazarin 33 (49%) na bayani ne da gwaji, 17 (25%) gwaji ne kawai, kuma 18 (26%) gwaji ne. Bayani ne kawai. Daga cikin nazarin gwaji 50 (73%), 21 (31%) sun yi amfani da bazuwar. Nazarin 34 kawai (50%) sun haɗa da nazarin ƙididdiga. Tebur 1 ya taƙaita halayen kowane binciken.
Labarai 33 (48%) sun binciki yankin kai, labarai 19 (28%) sun binciki yankin kirji, labarai 17 (25%) sun binciki yankin ciki, kuma labarai 15 (22%) sun binciki gaɓoɓi. Labarai 51 (75%) sun ambaci ƙasusuwan da aka buga 3D a matsayin samfuran jiki ko samfuran jiki masu sassaka da yawa.
Dangane da samfuran tushe ko fayilolin da aka yi amfani da su don ƙirƙirar 3DPAM, labarai 23 (34%) sun ambaci amfani da bayanan marasa lafiya, labarai 20 (29%) sun ambaci amfani da bayanan gawawwaki, kuma labarai 17 (25%) sun ambaci amfani da bayanan bayanai. an yi amfani da su, kuma bincike 7 (10%) ba su bayyana tushen takardun da aka yi amfani da su ba.
Nazari 47 (69%) sun haɓaka 3DPAM bisa ga lissafin tomography, kuma nazarce-nazarce 3 (4%) sun ba da rahoton amfani da microCT. Labarai 7 (10%) sun yi hasashen abubuwa 3D ta amfani da na'urorin daukar hoto, labarai 4 (6%) ta amfani da MRI, da kuma labarin 1 (1%) ta amfani da kyamarori da na'urorin hangen nesa. Labarai 14 (21%) ba su ambaci tushen fayilolin tushen ƙirar samfurin 3D ba. Ana ƙirƙirar fayilolin 3D tare da matsakaicin ƙudurin sarari na ƙasa da 0.5 mm. Mafi kyawun ƙuduri shine 30 μm [80] kuma matsakaicin ƙuduri shine 1.5 mm [32].
An yi amfani da manhajoji sittin daban-daban na software (rarrabawa, ƙira, ƙira ko bugawa). An fi amfani da Mimics (Materialise, Leuven, Belgium) (nazari 14, 21%), sai MeshMixer (Autodesk, San Rafael, CA) (nazari 13, 19%), Geomagic (3D System, MO, NC, Leesville). (Nazari 10, 15%), 3D Slicer (Slicer Developer Training, Boston, MA) (nazari 9, 13%), Blender (Blender Foundation, Amsterdam, Netherlands) (nazari 8, 12%) da CURA (Geldemarsen, Netherlands) (nazari 7, 10%).
An ambaci nau'ikan firinta daban-daban guda sittin da bakwai da kuma hanyoyin bugawa guda biyar. An yi amfani da fasahar FDM (Fused Deposition Modeling) a cikin kayayyaki 26 (38%), fashewar abu a cikin kayayyaki 13 (19%) da kuma fashewar binder (samfura 11, 16%). Fasahohin da ba a yi amfani da su sosai ba sune stereolithography (SLA) (samfura 5, 7%) da kuma zaɓaɓɓen laser sintering (SLS) (samfura 4, 6%). Firintar da aka fi amfani da ita (samfura 7, 10%) ita ce Connex 500 (Stratasys, Rehovot, Israel) [27, 30, 32, 36, 45, 62, 65].
Lokacin da ake tantance kayan da aka yi amfani da su wajen yin 3DPAM (kayayyaki 51, 75%), bincike 48 (71%) sun yi amfani da robobi da abubuwan da suka samo asali. Manyan kayan da aka yi amfani da su sune PLA (polylactic acid) (n = 20, 29%), resin (n = 9, 13%) da ABS (acrylonitrile butadiene styrene) (nau'ikan 7, 10%). Kayayyaki 23 (34%) sun binciki 3DPAM da aka yi daga kayan aiki da yawa, kayayyaki 36 (53%) sun gabatar da 3DPAM da aka yi daga kayan aiki ɗaya kawai, kuma kayayyaki 9 (13%) ba su ƙayyade wani abu ba.
Labarai ashirin da tara (43%) sun ruwaito rabon bugawa tsakanin 0.25:1 zuwa 2:1, tare da matsakaicin 1:1. Labarai ashirin da biyar (37%) sun yi amfani da rabon 1:1. 28 DPAMs 3 (41%) sun ƙunshi launuka da yawa, kuma 9 (13%) an rina su bayan bugawa [43, 46, 49, 54, 58, 59, 65, 69, 75].
Kasidu talatin da huɗu (50%) sun ambaci farashin. Kasidu tara (13%) sun ambaci farashin firintocin 3D da kayan aiki. Firintocin sun bambanta daga $302 zuwa $65,000. Idan aka ƙayyade, farashin samfura ya kama daga $1.25 zuwa $2,800; waɗannan tsauraran sun yi daidai da samfuran kwarangwal [47] da samfuran retroperitoneal masu inganci [48]. Tebur na 2 ya taƙaita bayanan samfurin don kowane binciken da aka haɗa.
Nazarin talatin da bakwai (54%) sun kwatanta 3DAPM da samfurin tunani. Daga cikin waɗannan nazarin, mafi yawan masu kwatantawa shine samfurin tunani na anatomical, wanda aka yi amfani da shi a cikin labarai 14 (38%), shirye-shiryen filastik a cikin labarai 6 (16%), shirye-shiryen filastik a cikin labarai 6 (16%). Amfani da gaskiyar kama-da-wane, hoton 3DPAM na lissafi ɗaya a cikin labarai 5 (14%), wani 3DPAM a cikin labarai 3 (8%), wasanni masu mahimmanci a cikin labarin 1 (3%), hotunan rediyo a cikin labarin 1 (3%), samfuran kasuwanci a cikin labarin 1 (3%) da gaskiyar da aka ƙara a cikin labarin 1 (3%). Nazarin talatin da huɗu (50%) sun kimanta 3DPAM. Nazarin goma sha biyar (48%) sun bayyana gogewar masu kimantawa dalla-dalla (Tebur 3). Likitocin tiyata ko likitoci da ke halartar binciken sun yi 3DPAM a cikin bincike 7 (47%), ƙwararrun ilimin halittar jiki a cikin bincike 6 (40%), ɗalibai a cikin bincike 3 (20%), malamai (ba a ƙayyade fannoni ba) a cikin bincike 3 (20%) don kimantawa da kuma wani mai kimantawa a cikin labarin (7%). Matsakaicin adadin masu kimantawa shine 14 (mafi ƙarancin 2, matsakaicin 30). Nazarin talatin da uku (49%) sun kimanta yanayin halittar 3DPAM ta hanyar inganci, kuma nazarin 10 (15%) sun tantance yanayin halittar 3DPAM ta hanyar adadi. Daga cikin nazarin 33 da suka yi amfani da kimantawa ta inganci, 16 sun yi amfani da kimantawa ta hanyar kwatantawa kawai (48%), gwaje-gwaje 9 sun yi amfani da su/ƙimar su (27%), da kuma ma'aunin Likert 8 sun yi amfani da su (24%). Tebur na 3 ya taƙaita kimantawa ta yanayin halittar samfuran a cikin kowane binciken da aka haɗa.
Labarai talatin da uku (48%) sun duba kuma sun kwatanta ingancin koyar da 3DPAM ga ɗalibai. Daga cikin waɗannan nazarin, labarai 23 (70%) sun tantance gamsuwar ɗalibai, 17 (51%) sun yi amfani da sikelin Likert, kuma 6 (18%) sun yi amfani da wasu hanyoyi. Labarai ashirin da biyu (67%) sun tantance koyo ta hanyar gwajin ilimi, wanda 10 (30%) sun yi amfani da gwaje-gwajen pretests da/ko bayan gwaje-gwaje. Nazarin goma sha ɗaya (33%) sun yi amfani da tambayoyi da gwaje-gwaje masu zaɓuɓɓuka da yawa don tantance ilimin ɗalibai, kuma nazarin biyar (15%) sun yi amfani da lakabin hoto/ganewar jiki. Matsakaicin ɗalibai 76 sun shiga cikin kowane bincike (mafi ƙarancin 8, matsakaicin 319). Nazarin ashirin da huɗu (72%) suna da ƙungiyar kulawa, wanda 20 (60%) sun yi amfani da bazuwar. Sabanin haka, wani bincike (3%) ya ba da samfuran jiki bazuwar ga ɗalibai 10 daban-daban. A matsakaici, an kwatanta ƙungiyoyi 2.6 (mafi ƙarancin 2, matsakaicin 10). Nazarin ashirin da uku (70%) ya shafi ɗaliban likitanci, waɗanda 14 (42%) ɗaliban likitanci ne na shekarar farko. Nazarin shida (18%) ya shafi mazauna, ɗaliban hakori 4 (12%), da ɗaliban kimiyya 3 (9%). Nazarin shida (18%) sun aiwatar kuma sun kimanta koyo mai zaman kansa ta amfani da 3DPAM. Tebur na 4 ya taƙaita sakamakon kimanta ingancin koyarwa na 3DPAM ga kowane binciken da aka haɗa.
Manyan fa'idodin da marubutan suka ruwaito game da amfani da 3DPAM a matsayin kayan aikin koyarwa don tsarin jikin ɗan adam na yau da kullun sune halaye na gani da na taɓawa, gami da ainihin gaskiya [55, 67], daidaito [44, 50, 72, 85], da bambancin daidaito [34, 45]. , 48, 64], launi da bayyanawa [28, 45], dorewa [24, 56, 73], tasirin ilimi [16, 32, 35, 39, 52, 57, 63, 69, 79], farashi [27, 41, 44, 45, 48, 51, 60, 64, 80, 81, 83], sake haifuwa [80], yiwuwar ingantawa ko keɓancewa [28, 30, 36, 45, 48, 51, 53, 59, 61, 67, 80], ikon sarrafa ɗalibai [30, 49], adana lokacin koyarwa [61, 80], sauƙin ajiya [61], ikon haɗa aikin jiki ko ƙirƙirar takamaiman tsari [51, 53], 67], ƙirar kwarangwal cikin sauri samfura [81], ikon ƙirƙirar samfura tare da kai su gida [49, 60, 71], inganta ƙwarewar juyawar tunani [23] da riƙe ilimi [32], da kuma kan malami [25, 63] da gamsuwar ɗalibai [25, 45, 46, 52, 52, 57, 63, 66, 69, 84].
Babban rashin amfanin yana da alaƙa da ƙira: tauri [80], daidaito [28, 62], rashin cikakkun bayanai ko bayyanawa [28, 30, 34, 45, 48, 62, 64, 81], launuka masu haske sosai [45]. da kuma raunin bene [71]. Sauran rashin amfanin sun haɗa da asarar bayanai [30, 76], tsawon lokacin da ake buƙata don raba hotuna [36, 52, 57, 58, 74], lokacin bugawa [57, 63, 66, 67], rashin bambancin tsarin jiki [25], da farashi. Babban [48].
Wannan bita mai tsari ya taƙaita labarai 68 da aka buga tsawon shekaru 9 kuma ya nuna sha'awar al'ummar kimiyya ga 3DPAM a matsayin kayan aiki don koyar da ilimin halittar ɗan adam na yau da kullun. An yi nazarin kowane yanki na tsarin halittar jiki kuma an buga shi da 3D. Daga cikin waɗannan labaran, labarai 37 sun kwatanta 3DPAM da sauran samfura, kuma labarai 33 sun tantance mahimmancin ilimin 3DPAM ga ɗalibai.
Ganin bambance-bambancen da ke cikin ƙirar nazarin bugun 3D na jikin mutum, ba mu ga ya dace mu gudanar da nazarin meta ba. Wani bincike na meta da aka buga a shekarar 2020 ya fi mayar da hankali kan gwaje-gwajen ilimin jikin mutum bayan horo ba tare da yin nazarin fannoni na fasaha da fasaha na ƙira da samarwa na 3DPAM ba [10].
Yankin kai shine mafi yawan bincike, wataƙila saboda sarkakiyar tsarin jikinsa yana sa ya fi wahala ga ɗalibai su zana wannan yankin jiki a sarari mai girma uku idan aka kwatanta da gaɓoɓi ko gaɓoɓi. CT shine mafi yawan hanyoyin daukar hoto da ake amfani da su. Ana amfani da wannan dabarar sosai, musamman a wuraren kiwon lafiya, amma tana da ƙarancin ƙudurin sarari da ƙarancin bambancin nama mai laushi. Waɗannan ƙuntatawa sun sa hotunan CT ba su dace da rabawa da yin kwaikwayon tsarin jijiyoyi ba. A gefe guda kuma, lissafin tomography ya fi dacewa da raba/yin ƙira na nama na ƙashi; Bambancin ƙashi/taushi nama yana taimakawa wajen kammala waɗannan matakai kafin a buga samfuran jiki na 3D. A gefe guda kuma, ana ɗaukar microCT a matsayin fasahar tunani dangane da ƙudurin sarari a cikin hoton ƙashi [70]. Ana iya amfani da na'urorin daukar hoto ko MRI don samun hotuna. Babban ƙuduri yana hana sassauta saman ƙashi kuma yana kiyaye ƙarancin tsarin jiki [59]. Zaɓin samfurin kuma yana shafar ƙudurin sarari: misali, samfuran filastik suna da ƙarancin ƙuduri [45]. Masu zane-zane dole ne su ƙirƙiri samfuran 3D na musamman, wanda ke ƙara farashi ($25 zuwa $150 a kowace awa) [43]. Samun fayilolin .STL masu inganci bai isa ba don ƙirƙirar samfuran jiki masu inganci. Ya zama dole a tantance sigogin bugawa, kamar yanayin samfurin jiki akan farantin bugawa [29]. Wasu marubuta sun ba da shawarar cewa ya kamata a yi amfani da fasahar bugawa ta zamani kamar SLS duk inda zai yiwu don inganta daidaiton 3DPAM [38]. Samar da 3DPAM yana buƙatar taimakon ƙwararru; ƙwararrun da aka fi nema sune injiniyoyi [72], masana kimiyyar rediyo, [75], masu zane-zanen hoto [43] da masana kimiyyar jiki [25, 28, 51, 57, 76, 77].
Rarrabawa da kuma yin samfuri software muhimmin abu ne wajen samun ingantattun samfuran jiki, amma farashin waɗannan fakitin software da sarkakiyar su na hana amfani da su. Nazarce-nazarce da dama sun kwatanta amfani da fakitin software daban-daban da fasahar bugawa, suna nuna fa'idodi da rashin amfanin kowace fasaha [68]. Baya ga software na yin samfuri, ana kuma buƙatar software na bugawa wanda ya dace da firintar da aka zaɓa; wasu marubuta sun fi son amfani da bugu na 3D akan layi [75]. Idan an buga isassun abubuwa na 3D, jarin zai iya haifar da ribar kuɗi [72].
Roba ita ce kayan da aka fi amfani da su. Yawaitar laushi da launukanta sun sa ta zama kayan da aka fi so ga 3DPAM. Wasu marubuta sun yaba da ƙarfinta idan aka kwatanta da samfuran gargajiya na cadaveric ko plastined [24, 56, 73]. Wasu robobi ma suna da kaddarorin lanƙwasa ko shimfiɗawa. Misali, Filaflex tare da fasahar FDM na iya shimfiɗa har zuwa 700%. Wasu marubuta suna ɗaukarta a matsayin kayan da aka fi so don kwafi na tsoka, jijiya da ligament [63]. A gefe guda kuma, bincike biyu sun tayar da tambayoyi game da tsarin zare yayin bugawa. A zahiri, tsarin zaren tsoka, sakawa, shiga ciki, da aiki suna da mahimmanci a cikin ƙirar tsoka [33].
Abin mamaki, ƙananan bincike sun ambaci girman bugawa. Tunda mutane da yawa suna ɗaukar rabon 1: 1 a matsayin daidaitacce, marubucin wataƙila bai zaɓi ambaton hakan ba. Duk da cewa haɓaka haɓakawa zai zama da amfani ga koyo a cikin manyan ƙungiyoyi, har yanzu ba a bincika yuwuwar ƙima ba, musamman tare da ƙaruwar girman aji da girman jiki na samfurin yana da mahimmanci. Tabbas, sikelin cikakken girma yana sauƙaƙa gano da kuma isar da abubuwa daban-daban na jiki ga majiyyaci, wanda zai iya bayyana dalilin da yasa ake yawan amfani da su.
Daga cikin firintocin da ake da su a kasuwa, waɗanda ke amfani da fasahar PolyJet (material ko binder inkjet) don samar da farashi mai inganci na launi da launuka masu yawa (sabili da haka launuka masu yawa) tsakanin dala 20,000 da dala 250,000 na Amurka (https: //www.aniwaa.com/). Wannan babban farashi na iya iyakance tallata 3DPAM a makarantun likitanci. Baya ga farashin firintar, farashin kayan da ake buƙata don buga inkjet ya fi na firintocin SLA ko FDM [68]. Farashin firintocin SLA ko FDM suma sun fi araha, daga €576 zuwa €4,999 a cikin labaran da aka jera a cikin wannan bita. A cewar Tripodi da abokan aiki, ana iya buga kowane ɓangaren kwarangwal akan dala 1.25 na Amurka [47]. Bincike goma sha ɗaya ya kammala da cewa bugawar 3D ta fi rahusa fiye da plasticization ko samfuran kasuwanci [24, 27, 41, 44, 45, 48, 51, 60, 63, 80, 81, 83]. Bugu da ƙari, waɗannan samfuran kasuwanci an tsara su ne don samar da bayanai ga majiyyaci ba tare da isasshen bayani ba don koyar da ilimin halittar jiki [80]. Waɗannan samfuran kasuwanci ana ɗaukar su ƙasa da 3DPAM [44]. Ya kamata a lura cewa, ban da fasahar bugawa da aka yi amfani da ita, farashin ƙarshe ya yi daidai da sikelin kuma saboda haka girman ƙarshe na 3DPAM [48]. Saboda waɗannan dalilai, ana fifita girman cikakken sikelin [37].
Bincike ɗaya ne kawai aka kwatanta da 3DPAM tare da samfuran jiki da ake samu a kasuwa [72]. Samfuran Cadaveric sune mafi yawan amfani da su don kwatantawa don 3DPAM. Duk da iyakokinsu, samfuran cadaveric sun kasance kayan aiki mai mahimmanci don koyar da ilimin halittar jiki. Dole ne a bambanta tsakanin gawawwakin mutum, rarrabawa da busasshen ƙashi. Dangane da gwaje-gwajen horo, bincike biyu sun nuna cewa 3DPAM ya fi tasiri fiye da rarrabawa ta filastik [16, 27]. Wani bincike ya kwatanta sa'a ɗaya na horo ta amfani da 3DPAM (ƙasa gaɓar jiki) tare da sa'a ɗaya na rarrabawa na yankin jiki ɗaya [78]. Babu wani bambanci mai mahimmanci tsakanin hanyoyin koyarwa guda biyu. Wataƙila akwai ƙaramin bincike kan wannan batu saboda irin waɗannan kwatancen suna da wahalar yi. Rarrabawa shiri ne mai ɗaukar lokaci ga ɗalibai. Wani lokaci ana buƙatar sa'o'i da yawa na shiri, ya danganta da abin da ake shiryawa. Ana iya yin kwatancen na uku da busassun ƙasusuwa. Wani bincike da Tsai da Smith suka yi ya gano cewa sakamakon gwaji ya fi kyau a cikin ƙungiyar ta amfani da 3DPAM [51, 63]. Chen da abokan aikinsa sun lura cewa ɗaliban da ke amfani da samfuran 3D sun yi aiki mafi kyau wajen gano tsarin (kwankwasa), amma babu wani bambanci a cikin maki na MCQ [69]. A ƙarshe, Tanner da abokan aikinsa sun nuna sakamako mafi kyau bayan gwaji a cikin wannan rukunin ta amfani da 3DPAM na pterygopalatine fossa [46]. An gano wasu sabbin kayan aikin koyarwa a cikin wannan bita na wallafe-wallafe. Mafi yawansu sune gaskiyar da aka ƙara, gaskiyar kama-da-wane da wasanni masu mahimmanci [43]. A cewar Mahrous da abokan aikinsa, fifiko ga samfuran jiki ya dogara da adadin sa'o'in da ɗalibai ke yin wasannin bidiyo [31]. A gefe guda kuma, babban koma-baya na sabbin kayan aikin koyarwa na jiki shine ra'ayoyin haptic, musamman ga kayan aikin kama-da-wane kawai [48].
Yawancin nazarin da ke kimanta sabon 3DPAM sun yi amfani da gwaje-gwajen ilimi na farko. Waɗannan gwaje-gwajen farko suna taimakawa wajen guje wa son zuciya a cikin kimantawa. Wasu marubuta, kafin gudanar da nazarin gwaji, ba su cire duk ɗaliban da suka sami maki sama da matsakaici a gwajin farko ba [40]. Daga cikin son zuciya da aka ambata Garas da abokan aikinsa akwai launin samfurin da zaɓin masu sa kai a cikin ajin ɗalibai [61]. Rini yana sauƙaƙa gano tsarin jiki. Chen da abokan aikinsa sun kafa yanayi na gwaji mai tsauri ba tare da bambance-bambancen farko tsakanin ƙungiyoyi ba kuma binciken ya makance har zuwa iyakar da zai yiwu [69]. Lim da abokan aikinsa sun ba da shawarar cewa wani ɓangare na uku ya kammala kimantawa bayan gwajin don guje wa son zuciya a cikin kimantawa [16]. Wasu nazarin sun yi amfani da ma'aunin Likert don tantance yuwuwar 3DPAM. Wannan kayan aikin ya dace da tantance gamsuwa, amma har yanzu akwai muhimman son zuciya da ya kamata a sani game da [86].
An fara tantance mahimmancin ilimi na 3DPAM a tsakanin ɗaliban likitanci, ciki har da ɗaliban likitanci na shekarar farko, a cikin bincike 14 daga cikin 33. A cikin binciken gwaji, Wilk da abokan aikinsa sun ba da rahoton cewa ɗaliban likitanci sun yi imanin cewa ya kamata a haɗa bugun 3D a cikin koyon ilimin jikinsu [87]. 87% na ɗaliban da aka yi wa tambayoyi a cikin binciken Cercenelli sun yi imanin cewa shekarar karatu ta biyu ita ce mafi kyawun lokacin amfani da 3DPAM [84]. Sakamakon Tanner da abokan aikinsa ya kuma nuna cewa ɗalibai sun yi aiki mafi kyau idan ba su taɓa yin nazarin fannin ba [46]. Waɗannan bayanai sun nuna cewa shekarar farko ta makarantar likitanci ita ce lokaci mafi kyau don haɗa 3DPAM cikin koyarwar ilimin jikin mutum. Nazarin meta na Ye ya goyi bayan wannan ra'ayin [18]. A cikin labarai 27 da aka haɗa a cikin binciken, akwai manyan bambance-bambance a cikin sakamakon gwaji tsakanin 3DPAM da samfuran gargajiya ga ɗaliban likitanci, amma ba ga mazauna ba.
3DPAM a matsayin kayan aikin ilmantarwa yana inganta nasarar ilimi [16, 35, 39, 52, 57, 63, 69, 79], riƙe ilimi na dogon lokaci [32], da gamsuwar ɗalibai [25, 45, 46, 52, 57, 63, 66]. , 69, 84]. Ƙungiyoyin kwararru sun kuma gano cewa waɗannan samfuran suna da amfani [37, 42, 49, 81, 82], kuma bincike biyu sun gano gamsuwar malamai da 3DPAM [25, 63]. Daga cikin dukkan majiyoyi, Backhouse da abokan aiki suna ɗaukar bugun 3D a matsayin mafi kyawun madadin samfuran jiki na gargajiya [49]. A cikin nazarin meta-bincike na farko, Ye da abokan aiki sun tabbatar da cewa ɗaliban da suka karɓi umarnin 3DPAM suna da mafi kyawun maki bayan gwaji fiye da ɗaliban da suka karɓi umarnin 2D ko gawarwaki [10]. Duk da haka, sun bambanta 3DPAM ba ta hanyar rikitarwa ba, amma ta hanyar zuciya, tsarin jijiyoyi, da kuma ramin ciki. A cikin bincike bakwai, 3DPAM bai yi fice ba a wasu samfura bisa ga gwaje-gwajen ilimi da aka yi wa ɗalibai [32, 66, 69, 77, 78, 84]. A cikin nazarinsu na meta-bincike, Salazar da abokan aikinsa sun kammala da cewa amfani da 3DPAM musamman yana inganta fahimtar tsarin jiki mai rikitarwa [17]. Wannan ra'ayi ya yi daidai da wasiƙar Hitas ga editan [88]. Wasu sassan tsarin jiki da aka ɗauka ba su da rikitarwa ba sa buƙatar amfani da 3DPAM, yayin da sassan tsarin jiki masu rikitarwa (kamar wuya ko tsarin jijiyoyi) za su zama zaɓi mai ma'ana ga 3DPAM. Wannan ra'ayi na iya bayyana dalilin da ya sa ba a ɗaukar wasu 3DPAMs a matsayin mafi kyau fiye da samfuran gargajiya ba, musamman lokacin da ɗalibai ba su da ilimi a fannin da aka ga aikin samfurin ya fi kyau. Don haka, gabatar da samfuri mai sauƙi ga ɗaliban da suka riga sun sami ɗan ilimin batun (ɗaliban likita ko mazauna) ba shi da taimako wajen inganta aikin ɗalibai.
Daga cikin dukkan fa'idodin ilimi da aka lissafa, bincike 11 sun jaddada halayen gani ko na taɓawa na samfura [27,34,44,45,48,50,55,63,67,72,85], kuma bincike 3 sun inganta ƙarfi da juriya (33, 50 -52, 63, 79, 85, 86). Sauran fa'idodin sune cewa ɗalibai za su iya sarrafa tsarin, malamai za su iya adana lokaci, sun fi sauƙin adanawa fiye da gawarwakin da aka kashe, ana iya kammala aikin cikin awanni 24, ana iya amfani da shi azaman kayan aikin koyar da gida, kuma ana iya amfani da shi don koyar da adadi mai yawa na bayanai. ƙungiyoyi [30, 49, 60, 61, 80, 81]. Buga 3D mai maimaitawa don koyar da jiki mai girma yana sa samfuran bugawa na 3D su fi araha [26]. Amfani da 3DPAM na iya inganta ƙarfin juyawar tunani [23] da inganta fassarar hotunan giciye [23, 32]. Nazarce-nazarce guda biyu sun gano cewa ɗaliban da suka kamu da 3DPAM sun fi fuskantar tiyata [40, 74]. Ana iya haɗa haɗin ƙarfe don ƙirƙirar motsi da ake buƙata don nazarin aikin jiki [51, 53], ko kuma ana iya buga samfuran ta amfani da ƙirar abubuwan jan hankali [67].
Bugawa ta 3D yana ba da damar ƙirƙirar samfuran jiki masu daidaitawa ta hanyar inganta wasu fannoni a lokacin matakin ƙira, [48, 80] ƙirƙirar tushe mai dacewa, [59] haɗa samfura da yawa, [36] ta amfani da bayyanawa, (49) launi, [45] ko kuma sanya wasu tsarin ciki a bayyane [30]. Tripodi da abokan aiki sun yi amfani da sassaka yumbu don ƙara wa samfuran ƙasusuwan da aka buga na 3D, suna jaddada darajar samfuran da aka ƙirƙira tare a matsayin kayan aikin koyarwa [47]. A cikin bincike 9, an yi amfani da launi bayan bugawa [43, 46, 49, 54, 58, 59, 65, 69, 75], amma ɗalibai sun yi amfani da shi sau ɗaya kawai [49]. Abin takaici, binciken bai kimanta ingancin horar da samfura ko jerin horo ba. Ya kamata a yi la'akari da wannan a cikin mahallin ilimin jikin mutum, saboda fa'idodin ilmantarwa mai gauraya da ƙirƙirar haɗin gwiwa an tabbatar da su sosai [89]. Domin magance karuwar ayyukan talla, an yi amfani da koyon kai sau da yawa don tantance samfura [24, 26, 27, 32, 46, 69, 82].
Wani bincike ya kammala da cewa launin kayan filastik ya yi haske sosai[45], wani bincike kuma ya kammala da cewa samfurin ya yi rauni sosai[71], wasu bincike biyu kuma sun nuna rashin bambancin tsarin jiki a cikin ƙirar samfuran mutum ɗaya[25, 45]. Bincike bakwai sun kammala da cewa cikakkun bayanai na tsarin jiki na 3DPAM bai isa ba [28, 34, 45, 48, 62, 63, 81].
Don ƙarin cikakkun samfuran jiki na manyan yankuna masu rikitarwa, kamar su retroperitoneum ko kashin baya na mahaifa, ana ɗaukar lokacin rabawa da yin samfuri mai tsawo sosai kuma farashin yana da yawa (kimanin dala 2000 na Amurka) [27, 48]. Hojo da abokan aikinsa sun bayyana a cikin bincikensu cewa ya ɗauki awanni 40 don ƙirƙirar samfurin jiki na ƙashin ƙugu [42]. Tsawon lokacin rabawa shine awanni 380 a cikin wani bincike da Weatherall da abokan aikinsa suka yi, inda aka haɗa samfura da yawa don ƙirƙirar cikakken samfurin iska na yara [36]. A cikin bincike tara, an ɗauki lokacin rabawa da bugawa a matsayin rashin amfani [36, 42, 57, 58, 74]. Duk da haka, bincike 12 sun soki halayen jiki na samfuran su, musamman daidaiton su, [28, 62] rashin bayyanawa, [30] rauni da monochromaticity, [71] rashin nama mai laushi, [66] ko rashin cikakkun bayanai [28, 34]. , 45, 48, 62, 63, 81]. Ana iya shawo kan waɗannan rashin amfanin ta hanyar ƙara lokacin rarrabawa ko kwaikwayon. Rasa da kuma dawo da bayanai masu dacewa matsala ce da ƙungiyoyi uku ke fuskanta [30, 74, 77]. A cewar rahotannin marasa lafiya, magungunan da aka yi da iodine ba su samar da ingantaccen ganuwa ga jijiyoyin jini ba saboda ƙarancin allurai [74]. Allurar samfurin adda ta zama hanya mafi kyau wacce ta kauce wa ƙa'idar "ƙarancin da zai yiwu" da iyakokin allurar maganin bambanci da aka yi wa allura.
Abin takaici, labarai da yawa ba su ambaci wasu muhimman fasalulluka na 3DPAM ba. Kasa da rabin labaran sun bayyana a sarari ko 3DPAM ɗinsu yana da launin toka. Rufe iyakokin bugawa bai daidaita ba (43% na labarai), kuma kashi 34% ne kawai suka ambaci amfani da kafofin watsa labarai da yawa. Waɗannan sigogin bugawa suna da mahimmanci saboda suna tasiri ga halayen koyo na 3DPAM. Yawancin labaran ba su bayar da isasshen bayani game da sarkakiyar samun 3DPAM (lokacin ƙira, cancantar ma'aikata, farashin software, farashin bugawa, da sauransu). Wannan bayanin yana da mahimmanci kuma ya kamata a yi la'akari da shi kafin a fara aiki don ƙirƙirar sabon 3DPAM.
Wannan bita mai tsari ya nuna cewa ƙira da buga 3D na samfuran jiki na yau da kullun yana yiwuwa a farashi mai rahusa, musamman lokacin amfani da firintocin FDM ko SLA da kayan filastik masu launi ɗaya masu araha. Duk da haka, ana iya haɓaka waɗannan ƙirar asali ta hanyar ƙara launi ko ƙara ƙira a cikin kayan aiki daban-daban. Ƙarin samfuran gaskiya (wanda aka buga ta amfani da kayayyaki da yawa na launuka daban-daban da laushi don kwaikwayon halayen taɓawa na samfurin ma'aunin gawawwaki) yana buƙatar ƙarin fasahar buga 3D mai tsada da tsawon lokacin ƙira. Wannan zai ƙara yawan farashi gaba ɗaya. Ko da wane tsari aka zaɓa, zaɓar hanyar hoto da ta dace shine mabuɗin nasarar 3DPAM. Mafi girman ƙudurin sarari, mafi girman samfurin yana zama gaskiya kuma ana iya amfani da shi don bincike mai zurfi. Daga mahangar koyarwa, 3DPAM kayan aiki ne mai tasiri don koyar da ilimin jiki, kamar yadda gwaje-gwajen ilimi da aka yi wa ɗalibai da gamsuwarsu suka nuna. Tasirin koyarwa na 3DPAM ya fi kyau lokacin da ya sake haifar da yankuna masu rikitarwa na jiki kuma ɗalibai suna amfani da shi da wuri a cikin horon likitancinsu.
Bayanan da aka samar da/ko aka yi nazari a kansu a cikin binciken na yanzu ba a samun su a bainar jama'a saboda matsalolin harshe amma ana samun su daga marubucin da ya dace bisa buƙata mai ma'ana.
Drake RL, Lowry DJ, Pruitt CM. Bita kan darussan tsarin jiki, ƙananan ƙwayoyin cuta, ilimin halittar jiki, da kuma ilimin haihuwa a cikin manhajar makarantun likitanci na Amurka. Anat Rec. 2002;269(2):118-22.
Ghosh SK Cadaveric dissection a matsayin kayan aikin ilimi don kimiyyar jiki a ƙarni na 21: Dissection a matsayin kayan aikin ilimi. Nazarin ilimin kimiyya. 2017;10(3):286–99.
Lokacin Saƙo: Afrilu-09-2024