Samfuran jikin mutum mai girma uku (3DPAMs) da alama kayan aiki ne masu dacewa saboda ƙimar ilimi da yuwuwar su.Manufar wannan bita shine don bayyanawa da kuma nazarin hanyoyin da aka yi amfani da su don ƙirƙirar 3DPAM don koyar da ilimin jikin ɗan adam da kuma kimanta gudunmawar iliminsa.
An gudanar da bincike na lantarki a cikin PubMed ta amfani da kalmomi masu zuwa: ilimi, makaranta, koyo, koyarwa, horo, koyarwa, ilimi, mai girma uku, 3D, 3-dimensional, bugu, bugu, bugu, jiki, jiki, jiki, da kuma jiki. ..Abubuwan da aka samo sun haɗa da halaye na nazari, ƙirar ƙira, ƙima na ilimin halitta, aikin ilimi, ƙarfi da rauni.
Daga cikin abubuwan da aka zaɓa na 68, mafi yawan adadin karatun da aka mayar da hankali kan yankin cranial (kasuwanci 33);51 articles ambaci kashi bugu.A cikin labarai guda 47, an haɓaka 3DPAM bisa ƙididdige hoto.An jera hanyoyin bugu biyar.An yi amfani da robobi da abubuwan da suka samo asali a cikin nazarin 48.Kowane ƙira yana cikin farashi daga $1.25 zuwa $2,800.Nazarin talatin da bakwai idan aka kwatanta 3DPAM tare da samfuran tunani.Labari talatin da uku sun yi nazarin ayyukan ilimi.Babban fa'idodin shine ingancin gani da tactile, ƙwarewar ilmantarwa, maimaitawa, daidaitawa da haɓakawa, tanadin lokaci, haɗaɗɗun jikin jiki na aiki, mafi kyawun jujjuyawar tunani, riƙe ilimi da gamsuwar malami / ɗalibi.Babban rashin amfani yana da alaƙa da zane-zane: daidaito, rashin cikakkun bayanai ko bayyanawa, launuka masu haske da yawa, lokuta masu tsayi da tsada.
Wannan bita na tsari yana nuna cewa 3DPAM yana da tsada-tasiri kuma yana da tasiri don koyar da ilimin jiki.Samfuran da suka fi dacewa suna buƙatar amfani da fasahohin bugu na 3D masu tsada da tsayin ƙira, wanda zai ƙara ƙimar gabaɗaya.Makullin shine zaɓi hanyar hoto mai dacewa.Daga ra'ayi na ilmantarwa, 3DPAM kayan aiki ne mai tasiri don koyar da ilimin jiki, tare da tasiri mai kyau akan sakamakon koyo da gamsuwa.Tasirin koyarwa na 3DPAM ya fi kyau lokacin da ya sake haifar da hadaddun yankuna na jiki kuma ɗalibai suna amfani da shi da wuri a cikin horon likitancin su.
Tun a zamanin d Girka ake yin tsinke gawarwakin dabbobi kuma yana daya daga cikin manyan hanyoyin koyar da jikin mutum.Ana amfani da ɓangarorin cadaveric da aka yi a lokacin horo na aiki a cikin ka'idodin ka'idodin ɗaliban likitancin jami'a kuma a halin yanzu ana ɗaukar ma'aunin zinare don nazarin ilimin halittar jiki [1,2,3,4,5].Koyaya, akwai shinge da yawa don amfani da samfuran cadaveric na ɗan adam, yana haifar da neman sabbin kayan aikin horo [6, 7].Wasu daga cikin waɗannan sabbin kayan aikin sun haɗa da haɓaka gaskiya, kayan aikin dijital, da bugu na 3D.Bisa ga nazarin wallafe-wallafen kwanan nan ta Santos et al.[8] Dangane da ƙimar waɗannan sabbin fasahohin don koyar da ilimin halittar jiki, bugu na 3D ya bayyana yana ɗaya daga cikin mahimman albarkatu, duka dangane da ƙimar ilimi ga ɗalibai kuma dangane da yuwuwar aiwatarwa [4,9,10] .
Buga 3D ba sabon abu bane.Halaye na farko masu alaƙa da wannan fasaha sun samo asali ne tun 1984: A Le Méhauté, O De Witte da JC André a Faransa, kuma bayan makonni uku C Hull a Amurka.Tun daga wannan lokacin, fasahar ta ci gaba da bunkasa kuma amfani da ita ya fadada zuwa wurare da yawa.Misali, NASA ta buga abu na farko bayan Duniya a cikin 2014 [11].Har ila yau, fannin likitanci ya karɓi wannan sabon kayan aiki, don haka yana ƙara sha'awar haɓaka magani na musamman [12].
Yawancin marubuta sun nuna fa'idodin yin amfani da samfuran anatomical na 3D da aka buga (3DPAM) a cikin ilimin likitanci [10, 13, 14, 15, 16, 17, 18, 19].Lokacin koyar da ilimin halittar ɗan adam, ana buƙatar samfuran marasa lafiya da na al'ada.Wasu sake dubawa sun bincika samfuran ilimin cututtuka ko na likita / tiyata [8, 20, 21].Don haɓaka samfurin matasan don koyar da ilimin jikin ɗan adam wanda ya haɗa da sababbin kayan aiki irin su bugu na 3D, mun gudanar da bita na yau da kullun don bayyanawa da kuma nazarin yadda aka ƙirƙiri abubuwan bugu na 3D don koyar da jikin ɗan adam da yadda ɗalibai ke kimanta tasirin koyo ta amfani da waɗannan abubuwan 3D.
An gudanar da wannan bita na wallafe-wallafen a cikin Yuni 2022 ba tare da ƙuntatawa na lokaci ba ta amfani da PRISMA (Abubuwan da aka Fi so don Rahoto na Tsare-tsare da Meta-Analyses) jagororin [22].
Sharuɗɗan haɗawa duk takaddun bincike ne ta amfani da 3DPAM a cikin koyarwa/koyon jikin mutum.Binciken wallafe-wallafe, haruffa, ko labaran da ke mai da hankali kan nau'ikan cututtukan cututtuka, ƙirar dabba, ƙirar archaeological, da samfuran horo na likita/na tiyata an cire su.An zaɓi labaran da aka buga cikin Ingilishi kawai.An cire labarai ba tare da samuwan taƙaitaccen bayanan kan layi ba.An haɗa labaran da suka haɗa da ƙira da yawa, aƙalla ɗaya daga cikinsu ya kasance na al'ada ta jiki ko kuma yana da ƙananan ƙwayoyin cuta waɗanda ba su tasiri darajar koyarwa ba.
An gudanar da binciken wallafe-wallafe a cikin bayanan lantarki na PubMed (National Library of Medicine, NCBI) don gano binciken da ya dace da aka buga har zuwa Yuni 2022. Yi amfani da kalmomin bincike masu zuwa: ilimi, makaranta, koyarwa, koyarwa, koyo, koyarwa, ilimi, uku- girma, 3D, 3D, bugu, bugu, bugu, Jiki, Jiki, Jiki da Jiki.An aiwatar da tambaya guda ɗaya: (((ilimi [Title/Abstract] KO makaranta[Title/Abstract] KO ilmantarwa[Title/Abstract] KO koyarwa[Title/Abstract] KO horo [Title/Abstract] OReach[Title/Abstract]] KO Ilimi [Title/Abstract]) DA (Mai Girma Uku [Title] KO 3D [Title] KO 3D [Title])) DA (Buga [Title] KO Buga [Title] KO Buga [Title])) DA (Anatomy) [Title ]]/abstract] ko anatomy [ take/abstract] ko kuma anatomy [title/abstract] ko anatomy [title/abstract]).An gano ƙarin labarai ta hanyar bincika bayanan PubMed da hannu da kuma bitar nassoshi na wasu labaran kimiyya.Ba a yi amfani da ƙuntatawa na kwanan wata ba, amma an yi amfani da tace "Mutum".
Dukkan taken da aka dawo da su an nuna su a kan haɗawa da ƙa'idodin keɓancewa ta marubuta biyu (EBR da AL), kuma duk wani binciken da bai cika duk ƙa'idodin cancanta ba an cire shi.Mawallafa uku (EBR, EBE da AL) ne aka dawo da su kuma suka sake duba wallafe-wallafen da suka rage na sauran karatun.Lokacin da ya cancanta, mutum na huɗu (LT) ya warware rashin jituwa a cikin zaɓin labaran.An haɗa wallafe-wallafen da suka cika duk ƙa'idodin haɗawa cikin wannan bita.
Marubuta biyu (EBR da AL) ne suka yi aikin hakar bayanai da kansu a ƙarƙashin kulawar marubuci na uku (LT).
- Bayanan ƙira na ƙira: yankuna na jiki, takamaiman sassa na jiki, ƙirar farko don bugu na 3D, hanyar saye, rarrabuwa da software na ƙirar ƙira, nau'in firinta na 3D, nau'in kayan abu da yawa, sikelin bugu, launi, farashin bugu.
- Ƙimar dabi'a na samfuri: ƙirar da aka yi amfani da su don kwatanta, kima na likita na masana / malamai, adadin masu kimantawa, nau'in kima.
- Koyar da samfurin 3D: kimanta ilimin ɗalibi, hanyar tantancewa, adadin ɗalibai, adadin ƙungiyoyin kwatanta, bazuwar ɗalibai, ilimi / nau'in ɗalibi.
An gano nazarin 418 a cikin MEDLINE, kuma an cire abubuwan 139 ta hanyar tace "mutum".Bayan yin bitar lakabi da taƙaitaccen bayani, an zaɓi nazarin 103 don karatun cikakken rubutu.An cire abubuwan 34 saboda sun kasance ko dai nau'ikan cututtukan cututtuka (kasuwanci 9), samfuran horo na likita / tiyata (labarai 4), ƙirar dabba (mabuɗin 4), samfuran rediyo na 3D (labarin 1) ko kuma ba ainihin labarin kimiyya bane (babi na 16).).An haɗa jimillar labarai 68 a cikin bita.Hoto na 1 yana gabatar da tsarin zaɓi azaman ginshiƙi mai gudana.
Jadawalin ginshiƙi yana taƙaita ganowa, dubawa, da haɗa labarai cikin wannan bita na tsari
An buga dukkan karatun tsakanin 2014 da 2022, tare da matsakaicin shekara ta 2019. Daga cikin 68 da aka haɗa da labarai, 33 (49%) binciken sun kasance ma'ana da gwaji, 17 (25%) sun kasance gwaji ne kawai, kuma 18 (26%) sun kasance gwaji ne kawai. na gwaji.Siffata zalla.Daga cikin 50 (73%) na binciken gwaji, 21 (31%) sunyi amfani da bazuwar.Nazarin 34 kawai (50%) sun haɗa da ƙididdigar ƙididdiga.Tebu na 1 yana taƙaita halayen kowane binciken.
Shafukan 33 (48%) sunyi nazarin yankin shugaban, 19 articles (28%) sunyi nazarin yankin thoracic, 17 articles (25%) sunyi nazarin yankin abdominopelvic, kuma 15 articles (22%) sunyi nazari akan iyakar.Labari hamsin da ɗaya (75%) sun ambaci ƙasusuwan da aka buga na 3D a matsayin ƙirar jikin mutum ko nau'ikan jikin mutum-yanki da yawa.
Game da samfurori ko fayilolin da aka yi amfani da su don bunkasa 3DPAM, 23 articles (34%) sun ambaci yin amfani da bayanan haƙuri, 20 articles (29%) sun ambaci amfani da bayanan cadaveric, kuma 17 articles (25%) sun ambaci amfani da bayanan bayanai.an yi amfani da su, kuma nazarin 7 (10%) bai bayyana tushen takardun da aka yi amfani da su ba.
Nazarin 47 (69%) ya haɓaka 3DPAM dangane da ƙididdigar ƙididdiga, kuma binciken 3 (4%) ya ba da rahoton amfani da microCT.7 articles (10%) an tsara abubuwan 3D ta amfani da na'urar daukar hoto, 4 articles (6%) ta amfani da MRI, da kuma labarin 1 (1%) ta amfani da kyamarori da microscopes.Labaran 14 (21%) ba su ambaci tushen fayilolin tushen ƙirar ƙirar ƙirar 3D ba.Fayilolin 3D an ƙirƙira su tare da matsakaicin ƙudurin sararin samaniya na ƙasa da 0.5 mm.Madaidaicin ƙuduri shine 30 μm [80] kuma matsakaicin ƙuduri shine 1.5 mm [32].
An yi amfani da aikace-aikacen software daban-daban sittin (bangare, ƙirar ƙira, ƙira ko bugu).An yi amfani da Mimics (Materialise, Leuven, Belgium) sau da yawa (nazarin 14, 21%), sannan MeshMixer (Autodesk, San Rafael, CA) (nazarin 13, 19%), Geomagic (Tsarin 3D, MO, NC, Leesville) .(10 karatu, 15%), 3D Slicer (Slicer Developer Training, Boston, MA) (9 karatu, 13%), Blender (Blender Foundation, Amsterdam, Netherlands) (8 karatu, 12%) da CURA (Geldemarsen, Netherlands) (Nazari 7, 10%).
Sittin da bakwai nau'ikan nau'ikan firinta daban-daban da ayyukan bugu biyar an ambata.An yi amfani da fasahar FDM (Fused Deposition Modeling) a cikin samfuran 26 (38%), fashewar abu a cikin samfuran 13 (19%) kuma a ƙarshe fashewar fashewar abubuwa (kayayyaki 11, 16%).Mafi ƙarancin fasahar da aka yi amfani da su sune stereolithography (SLA) (labarai 5, 7%) da zaɓin laser sintering (SLS) (lasidu 4, 6%).Fitar da aka fi amfani da ita (labulai 7, 10%) shine Connex 500 (Stratasys, Rehovot, Isra'ila) [27, 30, 32, 36, 45, 62, 65].
Lokacin ƙayyadaddun kayan da aka yi amfani da su don yin 3DPAM (labulen 51, 75%), nazarin 48 (71%) sun yi amfani da robobi da abubuwan da suka samo asali.Babban kayan da aka yi amfani da su sune PLA (polylactic acid) (n = 20, 29%), resin (n = 9, 13%) da ABS (acrylonitrile butadiene styrene) (7 iri, 10%).Abubuwan 23 (34%) sunyi nazarin 3DPAM da aka yi daga abubuwa masu yawa, 36 articles (53%) sun gabatar da 3DPAM da aka yi daga abu ɗaya kawai, kuma 9 articles (13%) ba su ƙayyade wani abu ba.
Labari ashirin da tara (43%) sun ba da rahoton rabon bugu daga 0.25:1 zuwa 2:1, tare da matsakaita na 1:1.Labari ashirin da biyar (37%) sun yi amfani da rabon 1:1.28 3DPAMs (41%) sun ƙunshi launuka masu yawa, kuma 9 (13%) an rina su bayan bugawa [43, 46, 49, 54, 58, 59, 65, 69, 75].
Labari talatin da huɗu (50%) an ambata farashi.Labaran 9 (13%) sun ambaci farashin firintocin 3D da albarkatun ƙasa.Na'urorin bugawa suna da farashi daga $302 zuwa $65,000.Lokacin da aka ƙayyade, farashin samfurin ya tashi daga $1.25 zuwa $2,800;waɗannan matsananciyar sun dace da samfuran kwarangwal [47] da samfuran retroperitoneal masu inganci [48].Tebu na 2 yana taƙaita bayanan ƙirar don kowane binciken da aka haɗa.
Nazarin talatin da bakwai (54%) idan aka kwatanta 3DAPM zuwa samfurin tunani.Daga cikin waɗannan karatun, mafi yawan kwatancen kwatancen shine samfurin tunani na anatomical, wanda aka yi amfani da shi a cikin labaran 14 (38%), shirye-shiryen plastinated a cikin labaran 6 (16%), shirye-shiryen plastinated a cikin labaran 6 (16%).Amfani da zahirin gaskiya, kwatancen hoton hoto guda 3DPAM a cikin labaran 5 (14%), wani 3DPAM a cikin labaran 3 (8%), wasanni masu mahimmanci a cikin labarin 1 (3%), radiyo a cikin labarin 1 (3%), samfuran kasuwanci a ciki 1 labarin (3%) da haɓaka gaskiya a cikin labarin 1 (3%).Nazarin talatin da huɗu (50%) sun tantance 3DPAM.Nazari goma sha biyar (48%) sun bayyana abubuwan da masu kima suka samu daki-daki (Table 3).3DPAM an yi ta likitocin tiyata ko halartar likitoci a cikin binciken 7 (47%), ƙwararrun ƙwararrun jiki a cikin karatun 6 (40%), ɗalibai a cikin karatun 3 (20%), malamai ( horon da ba a ƙayyade ba) a cikin karatun 3 (20%) don kimantawa. da ƙarin mai kimantawa ɗaya a cikin labarin (7%).Matsakaicin adadin masu kimantawa shine 14 (mafi ƙarancin 2, matsakaicin 30).Nazarin talatin da uku (49%) sun kimanta ilimin halittar jiki na 3DPAM da inganci, kuma binciken 10 (15%) ya kimanta 3DPAM ilimin halittar jiki da yawa.Daga cikin binciken 33 da suka yi amfani da ƙima mai inganci, 16 sun yi amfani da ƙima mai ƙima kawai (48%), 9 sunyi amfani da gwaje-gwaje / ƙididdiga / bincike (27%), kuma 8 sunyi amfani da ma'aunin Likert (24%).Tebu na 3 yana taƙaita ƙididdigar ƙima na ƙirar a cikin kowane binciken da aka haɗa.
Labari talatin da uku (48%) sun bincika kuma sun kwatanta tasirin koyarwar 3DPAM ga ɗalibai.Daga cikin waɗannan karatun, labaran 23 (70%) sun tantance gamsuwar ɗalibai, 17 (51%) sun yi amfani da ma'aunin Likert, kuma 6 (18%) sun yi amfani da wasu hanyoyin.Labari ashirin da biyu (67%) sun tantance koyon ɗalibi ta hanyar gwajin ilimi, waɗanda 10 (30%) suka yi amfani da pretests da/ko posttess.Nazari goma sha ɗaya (33%) sun yi amfani da tambayoyi da gwaje-gwaje na zaɓi da yawa don tantance ilimin ɗalibai, kuma binciken biyar (15%) sun yi amfani da alamar hoto/ganewar jikin mutum.Matsakaicin ɗalibai 76 sun shiga cikin kowane binciken (mafi ƙarancin 8, matsakaicin 319).Nazarin ashirin da hudu (72%) suna da ƙungiyar kulawa, wanda 20 (60%) yayi amfani da bazuwar.Sabanin haka, binciken daya (3%) ba da gangan aka sanya nau'in halittar jiki ga ɗalibai 10 daban-daban.A matsakaita, an kwatanta ƙungiyoyi 2.6 (mafi ƙarancin 2, matsakaicin 10).Nazarin 23 (70%) sun haɗa da ɗaliban likitanci, waɗanda 14 (42%) su ne ɗaliban likitanci na shekara ta farko.Nazarin shida (18%) sun shafi mazauna, 4 (12%) ɗaliban hakori, da 3 (9%) ɗaliban kimiyya.Nazarin shida (18%) aiwatarwa da kimanta koyo mai zaman kansa ta amfani da 3DPAM.Teburin 4 ya taƙaita sakamakon 3DPAM ƙimar ingancin koyarwa ga kowane binciken da aka haɗa.
Babban fa'idodin da marubutan suka bayar don amfani da 3DPAM azaman kayan aikin koyarwa don ilimin halittar ɗan adam na yau da kullun sune halaye na gani da tactile, gami da gaskiyar [55, 67], daidaito [44, 50, 72, 85], da daidaituwar daidaituwa [34, 45] ].. 41, 44, 45, 48, 51, 60, 64, 80, 81, 83], reproducibility [80], yuwuwar ingantawa ko keɓancewa [28, 30, 36, 45, 48, 51, 53, 59, 61, 67, 80], da ikon sarrafa dalibai [30, 49], ceton lokacin koyarwa [61, 80], sauƙi na ajiya [61], ikon haɗawa da aikin jiki ko ƙirƙirar takamaiman tsari [51, 53], 67] , saurin ƙira na ƙirar kwarangwal [81], da ikon ƙirƙirar samfura da kai su gida [49, 60, 71], haɓaka ƙarfin jujjuyawar tunani [23] da riƙe ilimi [32], da kuma a kan malami [32] 25, 63] da gamsuwar ɗalibi [25, 45, 46, 52, 52, 57, 63, 66, 69, 84].
Babban rashin amfani yana da alaƙa da ƙira: rigidity [80], daidaito [28, 62], rashin cikakken bayani ko bayyanawa [28, 30, 34, 45, 48, 62, 64, 81], launuka masu haske [45].da raunin kasa[71].Sauran rashin lahani sun haɗa da asarar bayanai [30, 76], dogon lokaci da ake buƙata don rarraba hoto [36, 52, 57, 58, 74], lokacin bugu [57, 63, 66, 67], rashin canjin yanayin jiki [25], da tsada.Babban[48].
Wannan bita na tsari ya taƙaita labarai 68 da aka buga sama da shekaru 9 kuma yana nuna sha'awar al'ummar kimiyya ga 3DPAM a matsayin kayan aiki don koyar da yanayin jikin ɗan adam na yau da kullun.An yi nazarin kowane yanki na jiki kuma an buga 3D.Daga cikin waɗannan labaran, labaran 37 sun kwatanta 3DPAM tare da wasu samfura, kuma labaran 33 sun tantance mahimmancin koyarwa na 3DPAM ga ɗalibai.
Ganin bambance-bambance a cikin ƙira na nazarin bugun 3D na jiki, ba mu yi la'akari da ya dace don gudanar da bincike-bincike ba.Wani meta-bincike da aka buga a cikin 2020 ya fi mayar da hankali kan gwaje-gwajen ilimin halittar jiki bayan horo ba tare da yin nazarin fasahohin fasaha da fasaha na ƙira da samarwa na 3DPAM [10].
Babban yankin shi ne aka fi yin nazari, mai yiwuwa saboda sarƙaƙƙiyar tsarin halittarsa yana sa ɗalibai su iya kwatanta wannan yanki mai girma a sararin samaniya mai girma uku idan aka kwatanta da gaɓoɓi ko gaɓa.CT ita ce mafi yawan amfani da tsarin hoto.Ana amfani da wannan fasaha sosai, musamman a cikin saitunan likita, amma yana da ƙayyadaddun ƙayyadaddun sararin samaniya da ƙananan bambancin nama mai laushi.Wadannan iyakoki suna sa CT scans bai dace da rarrabuwa da ƙirar tsarin juyayi ba.A gefe guda, ƙididdigar ƙididdiga ya fi dacewa da kashi na nama / ƙirar ƙira;Bambancin nama / taushi yana taimakawa don kammala waɗannan matakan kafin 3D bugu samfurin jikin mutum.A gefe guda, ana ɗaukar microCT azaman fasahar tunani dangane da ƙudurin sararin samaniya a cikin hoton kashi [70].Hakanan ana iya amfani da na'urar daukar hoto ko MRI don samun hotuna.Ƙaddamarwa mafi girma yana hana santsin saman kashi kuma yana adana dabarar sifofin jiki [59].Zaɓin ƙirar kuma yana rinjayar ƙudurin sararin samaniya: alal misali, ƙirar filastik suna da ƙaramin ƙuduri [45].Masu zanen zane dole ne su ƙirƙiri ƙirar 3D na al'ada, wanda ke haɓaka farashi ($ 25 zuwa $ 150 a kowace awa) [43].Samun fayilolin .STL masu inganci bai isa ya ƙirƙira ƙirar ƙira mai inganci ba.Wajibi ne a ƙayyade sigogin bugu, kamar daidaitawar ƙirar jikin mutum akan farantin bugu [29].Wasu marubuta suna ba da shawarar cewa ya kamata a yi amfani da fasahar bugu na ci gaba kamar SLS a duk inda zai yiwu don inganta daidaiton 3DPAM [38].Samar da 3DPAM yana buƙatar taimakon ƙwararru;ƙwararrun ƙwararrun da aka fi nema su ne injiniyoyi [72], masu aikin rediyo, [75], masu zanen hoto [43] da masu ilimin halittar jiki [25, 28, 51, 57, 76, 77].
Rarraba software da ƙirar ƙira sune mahimman dalilai don samun ingantattun ƙirar ƙira, amma farashin waɗannan fakitin software da sarkar su suna hana amfani da su.Yawancin karatu sun kwatanta amfani da fakitin software daban-daban da fasahohin bugu, suna nuna fa'ida da rashin amfanin kowace fasaha [68].Baya ga kera manhaja, ana kuma buqatar bugu software da ta dace da firinta da aka zaɓa;wasu marubuta sun fi son yin amfani da bugu na 3D akan layi [75].Idan an buga isassun abubuwan 3D, saka hannun jari na iya haifar da dawo da kuɗi [72].
Filastik ita ce kayan da aka fi amfani da su.Yawan nau'in laushi da launuka ya sa ya zama kayan zaɓi na 3DPAM.Wasu marubuta sun yaba da babban ƙarfinsa idan aka kwatanta da na gargajiya cadaveric ko plastinated model [24, 56, 73].Wasu robobi ma suna da abubuwan lanƙwasa ko miƙewa.Misali, Filaflex tare da fasahar FDM na iya shimfiɗa har zuwa 700%.Wasu marubuta suna la'akari da shi kayan da aka zaɓa don tsoka, tendon da ligament maimaitawa [63].A gefe guda kuma, binciken biyu ya haifar da tambayoyi game da daidaitawar fiber yayin bugu.A zahiri, daidaitawar fiber tsoka, sakawa, haɓakawa, da aiki suna da mahimmanci a ƙirar tsoka [33].
Abin mamaki, ƙananan bincike sun ambaci ma'aunin bugu.Tun da mutane da yawa suna ɗaukar rabon 1:1 a matsayin ma'auni, mai yiwuwa marubucin ya zaɓi kada ya ambace shi.Kodayake haɓakawa zai zama da amfani ga ilmantarwa da aka ba da umarni a cikin manyan ƙungiyoyi, har yanzu ba a bincika yuwuwar sikelin ba, musamman tare da girma girma na aji da girman jiki na ƙirar zama muhimmin abu.Tabbas, cikakken ma'auni yana ba da sauƙi don ganowa da kuma sadarwa abubuwa daban-daban ga majiyyaci, wanda zai iya bayyana dalilin da yasa ake amfani da su sau da yawa.
Daga cikin manyan fayiloli da ake samu a kasuwa, waɗanda ke amfani da polyjet (kayan masarufi na Boder) Fasaha don samar da launi da $ 20,000 kuma $ 250,000 (https: // www .aniwaa.com/).Wannan babban farashi na iya iyakance haɓakar 3DPAM a makarantun likitanci.Baya ga farashin firinta, farashin kayan da ake buƙata don buga tawada ya fi na SLA ko FDM firintocin [68].Farashin na firintocin SLA ko FDM suma sun fi araha, kama daga €576 zuwa €4,999 a cikin labaran da aka jera a wannan bita.A cewar Tripodi da abokan aiki, kowane ɓangaren kwarangwal ana iya buga shi akan dalar Amurka $1.25 [47].Nazarin goma sha ɗaya sun kammala cewa bugu na 3D ya fi rahusa fiye da filastik ko samfuran kasuwanci [24, 27, 41, 44, 45, 48, 51, 60, 63, 80, 81, 83].Bugu da ƙari, waɗannan samfuran kasuwanci an tsara su don samar da bayanan haƙuri ba tare da cikakkun bayanai ba don koyarwar jiki [80].Ana ɗaukar waɗannan samfuran kasuwanci ƙasa da 3DPAM [44].Yana da mahimmanci a lura cewa, ban da fasahar bugawa da aka yi amfani da ita, farashin ƙarshe ya yi daidai da ma'auni kuma saboda haka girman ƙarshe na 3DPAM [48].Don waɗannan dalilai, an fi son cikakken ma'auni [37].
Nazarin guda ɗaya kawai idan aka kwatanta 3DPAM tare da samfuran anatomical na kasuwanci [72].Samfuran cadaveric sune mafi yawan amfani da kwatancen 3DPAM.Duk da iyakokin su, ƙirar cadaveric sun kasance kayan aiki mai mahimmanci don koyar da ilimin jiki.Dole ne a bambanta tsakanin gawa, rarrabawa da bushe kashi.Dangane da gwaje-gwajen horo, binciken biyu ya nuna cewa 3DPAM ya fi tasiri sosai fiye da rarraba plastinated [16, 27].Ɗaya daga cikin binciken idan aka kwatanta da sa'a daya na horo ta amfani da 3DPAM (ƙananan iyakar) tare da sa'a daya na rarrabawa na yanki guda ɗaya [78].Babu wani gagarumin bambanci tsakanin hanyoyin koyarwa guda biyu.Wataƙila akwai ɗan bincike kan wannan batu saboda irin wannan kwatancen yana da wahala a yi.Dissection shiri ne mai cin lokaci ga ɗalibai.Wani lokaci ana buƙatar dozin na sa'o'i na shirye-shirye, dangane da abin da ake shiryawa.Ana iya kwatanta kwatancen na uku tare da busassun ƙasusuwa.Wani binciken da Tsai da Smith suka yi ya gano cewa ƙimar gwajin sun fi kyau a cikin rukuni ta amfani da 3DPAM [51, 63].Chen da abokan aiki sun lura cewa ɗalibai masu amfani da nau'ikan 3D sun yi aiki mafi kyau akan gano sifofi (kwayoyin kai), amma babu bambanci a maki MCQ [69].A ƙarshe, Tanner da abokan aiki sun nuna mafi kyawun sakamakon gwajin bayan gwajin a cikin wannan rukunin ta amfani da 3DPAM na pterygopalatine fossa [46].An gano wasu sabbin kayan aikin koyarwa a cikin wannan bitar wallafe-wallafe.Mafi na kowa a cikinsu akwai haɓakar gaskiya, gaskiya mai kama da gaske da wasanni masu tsanani [43].A cewar Mahrous da abokan aiki, fifiko ga ƙirar jikin mutum ya dogara da adadin sa'o'in ɗalibai suna yin wasannin bidiyo [31].A gefe guda, babban koma baya na sabbin kayan aikin koyarwar ilimin jiki shine ra'ayi mai ban tsoro, musamman don kayan aikin kama-da-wane kawai [48].
Yawancin binciken da ke kimanta sabon 3DPAM sun yi amfani da pretests na ilimi.Waɗannan pretests suna taimakawa guje wa son zuciya a cikin kima.Wasu mawallafa, kafin su gudanar da nazarin gwaji, sun ware duk ɗaliban da suka ci sama da matsakaita akan gwajin farko [40].Daga cikin ra'ayoyin Garas da abokan aiki da aka ambata sun hada da launi na samfurin da zaɓin masu sa kai a cikin ɗaliban ɗalibai [61].Tabon yana sauƙaƙe gano tsarin jikin mutum.Chen da abokan aiki sun kafa tsauraran yanayin gwaji ba tare da bambance-bambancen farko tsakanin kungiyoyi ba kuma binciken ya makanta har zuwa iyakar yiwuwar [69].Lim da abokan aiki sun ba da shawarar cewa wani ɓangare na uku ya kammala kima bayan gwajin don guje wa son zuciya a cikin kima [16].Wasu nazarin sunyi amfani da ma'aunin Likert don tantance yiwuwar 3DPAM.Wannan kayan aikin ya dace don tantance gamsuwa, amma har yanzu akwai mahimman abubuwan son rai don sanin [86].
An tantance mahimmancin ilimi na 3DPAM a tsakanin ɗaliban likitanci, gami da ɗaliban likitanci na farko, a cikin 14 na karatun 33.A cikin binciken matukin jirgi, Wilk da abokan aikinsu sun ba da rahoton cewa ɗaliban likitanci sun yi imanin cewa ya kamata a haɗa bugu na 3D a cikin koyon ilimin halittar jiki [87].87% na ɗaliban da aka bincika a cikin binciken Cercenelli sun yi imanin cewa shekara ta biyu na binciken ita ce mafi kyawun lokacin amfani da 3DPAM [84].Sakamakon Tanner da abokan aikin ya kuma nuna cewa ɗalibai sun yi aiki mafi kyau idan ba su taɓa yin nazarin filin ba [46].Waɗannan bayanan suna ba da shawarar cewa shekarar farko ta makarantar likitanci ita ce mafi kyawun lokacin haɗa 3DPAM cikin koyarwar jikin mutum.Nazarin meta-nazari ya goyi bayan wannan ra'ayin [18].A cikin abubuwan 27 da aka haɗa a cikin binciken, akwai bambance-bambance masu mahimmanci a cikin ƙimar gwaji tsakanin 3DPAM da ƙirar gargajiya don ɗaliban likitanci, amma ba ga mazauna ba.
3DPAM a matsayin kayan aikin ilmantarwa yana haɓaka nasarar ilimi [16, 35, 39, 52, 57, 63, 69, 79], riƙe ilimi na dogon lokaci [32], da gamsuwar ɗalibi [25, 45, 46, 52, 57, 63 , 66]., 69 , 84 ].Ƙungiyoyin masana kuma sun sami waɗannan samfuran suna da amfani [37, 42, 49, 81, 82], kuma binciken biyu sun sami gamsuwar malami tare da 3DPAM [25, 63].Daga cikin dukkan tushe, Gidan baya da abokan aiki suna la'akari da bugu na 3D don zama mafi kyawun madadin tsarin halittar jiki na gargajiya [49].A cikin meta-bincike na farko, Ye da abokan aiki sun tabbatar da cewa ɗaliban da suka karɓi umarnin 3DPAM suna da mafi kyawun maki bayan gwajin fiye da ɗaliban da suka karɓi 2D ko umarnin cadaver [10].Duk da haka, sun bambanta 3DPAM ba ta hanyar rikitarwa ba, amma kawai ta hanyar zuciya, tsarin jin tsoro, da kuma rami na ciki.A cikin binciken bakwai, 3DPAM ba ta fi sauran samfura ba dangane da gwajin ilimin da aka gudanar ga ɗalibai [32, 66, 69, 77, 78, 84].A cikin meta-bincike, Salazar da abokan aiki sun kammala cewa amfani da 3DPAM musamman yana inganta fahimtar hadaddun jikin mutum [17].Wannan ra'ayi ya yi daidai da wasiƙar Hitas zuwa ga edita [88].Wasu yankunan anatomical da aka yi la'akari da ƙananan hadaddun ba sa buƙatar amfani da 3DPAM, yayin da ƙarin wuraren da ke tattare da jiki (kamar wuyansa ko tsarin juyayi) zai zama zaɓi na ma'ana don 3DPAM.Wannan ra'ayi na iya yin bayanin dalilin da ya sa ba a ɗauka wasu 3DPAMs sun fi na al'ada ba, musamman ma lokacin da dalibai ba su da ilimi a cikin yanki inda aka sami aikin samfurin ya fi girma.Don haka, gabatar da samfuri mai sauƙi ga ɗaliban da suka riga sun sami ɗan ilimin batun (daliban likitanci ko mazauna) ba su da taimako wajen haɓaka aikin ɗalibi.
Daga cikin duk fa'idodin ilimi da aka jera, binciken 11 ya jaddada halayen gani ko tactile na samfuri [27,34,44,45,48,50,55,63,67,72,85], da kuma karatun 3 sun inganta ƙarfi da dorewa (33) , 50 -52, 63, 79, 85, 86).Sauran abũbuwan amfãni shi ne cewa dalibai na iya sarrafa tsarin, malamai na iya ajiye lokaci, sun fi sauƙi don adanawa fiye da cadavers, ana iya kammala aikin a cikin sa'o'i 24, ana iya amfani da shi azaman kayan aikin gida, kuma ana iya amfani dashi don koyar da adadi mai yawa. na bayanai.rukunoni [30, 49, 60, 61, 80, 81].Maimaita bugu na 3D don koyarwar ilimin jikin mutum mai girma yana sa ƙirar bugu na 3D ya fi tasiri mai tsada [26].Yin amfani da 3DPAM na iya inganta ƙarfin jujjuyawar tunani [23] da kuma inganta fassarar hotuna masu ƙetare [23, 32].Nazarin guda biyu sun gano cewa ɗaliban da aka fallasa zuwa 3DPAM sun fi fuskantar tiyata [40, 74].Ana iya shigar da masu haɗin ƙarfe don ƙirƙirar motsin da ake buƙata don nazarin aikin jiki [51, 53], ko kuma ana iya buga samfura ta amfani da ƙirar ƙira [67].
3D bugu yana ba da damar ƙirƙirar samfuran daidaitacce ta hanyar haɓaka wasu al'amura yayin matakin ƙirar, [48, 80] ƙirƙirar tushe mai dacewa, [59] haɗa nau'ikan samfura da yawa, [36] ta amfani da nuna gaskiya, (49) launi, [45] ko yin wasu sifofi na ciki a bayyane [30].Tripodi da abokan aiki sun yi amfani da yumbu mai sassaka don haɓaka ƙirar ƙasusuwan su na 3D da aka buga, suna jaddada ƙimar samfuran haɗin gwiwa azaman kayan aikin koyarwa [47].A cikin nazarin 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 horon samfurin ko jerin horo ba.Wannan ya kamata a yi la'akari da shi a cikin ilimin ilimin jiki, kamar yadda fa'idodin ilmantarwa da haɗin kai sun kafu sosai [89].Don jimre da haɓaka ayyukan talla, an yi amfani da koyon kai sau da yawa don kimanta ƙima [24, 26, 27, 32, 46, 69, 82].
Ɗaya daga cikin binciken ya kammala cewa launi na kayan filastik yana da haske sosai[45], wani binciken kuma ya kammala cewa samfurin ya kasance mai rauni sosai [71], kuma wasu nazarin guda biyu sun nuna rashin daidaituwa na jiki a cikin ƙirar mutum ɗaya [25, 45]. ]..Nazarin bakwai sun kammala cewa cikakkun bayanai na jikin mutum na 3DPAM bai isa ba [28, 34, 45, 48, 62, 63, 81].
Don ƙarin cikakkun nau'ikan nau'ikan halittu masu girma da hadaddun yankuna, kamar retroperitoneum ko kashin mahaifa, ana ɗaukar yanki da lokacin ƙirar ƙira sosai kuma farashin yana da yawa (kimanin dalar Amurka 2000) [27, 48].Hojo da abokan aiki sun bayyana a cikin binciken su cewa an ɗauki sa'o'i 40 don ƙirƙirar samfurin jikin ƙashin ƙugu [42].Mafi tsayin lokacin rabuwa shine sa'o'i 380 a cikin binciken Weatherall da abokan aiki, wanda aka haɗa nau'ikan samfura da yawa don ƙirƙirar cikakkiyar ƙirar hanyar iska ta yara [36].A cikin karatun tara, an yi la'akari da rarrabawa da lokacin bugawa a matsayin rashin amfani [36, 42, 57, 58, 74].Duk da haka, nazarin 12 ya soki kaddarorin jiki na samfurin su, musamman ma daidaitattun su, [28, 62] rashin gaskiya, [30] rashin ƙarfi da monochromaticity, [71] rashin nama mai laushi, [66] ko rashin cikakkun bayanai [28, 34]., 45, 48, 62, 63, 81].Ana iya shawo kan waɗannan lahani ta hanyar ƙara yawan lokaci ko lokacin kwaikwayo.Rasa da dawo da bayanan da suka dace matsala ce da ƙungiyoyi uku suka fuskanta [30, 74, 77].Dangane da rahotannin haƙuri, wakilai masu bambanta iodinated ba su samar da mafi kyawun gani na jijiyoyin jini ba saboda iyakokin kashi [74].Allurar da samfurin cadaveric alama alama ce mai kyau hanyar da ta ƙaura daga ka'idar "ƙandan zai yiwu" da kuma iyakokin kashi na nau'in bambancin allura.
Abin takaici, labarai da yawa ba su ambaci wasu mahimman fasalulluka na 3DPAM ba.Kasa da rabin labaran da aka bayyana a sarari ko 3DPAM ɗin su yana da tinted.Rufe iyakokin bugu bai dace ba (43% na labarai), kuma 34% kawai ya ambaci amfani da kafofin watsa labarai da yawa.Waɗannan sigogin bugu suna da mahimmanci saboda suna tasiri abubuwan koyo na 3DPAM.Yawancin labaran ba su samar da isassun bayanai game da rikitattun samun 3DPAM (lokacin ƙira, cancantar ma'aikata, farashin software, farashin bugu, da sauransu).Wannan bayanin yana da mahimmanci kuma yakamata a yi la'akari da shi kafin fara tunanin fara aiki don haɓaka sabon 3DPAM.
Wannan bita na tsari ya nuna cewa ƙira da 3D bugu na yau da kullun na anatomical yana yiwuwa a farashi mai sauƙi, musamman lokacin amfani da firintocin FDM ko SLA da kayan filastik masu launi ɗaya marasa tsada.Duk da haka, waɗannan ƙirar ƙira za a iya haɓaka ta hanyar ƙara launi ko ƙara ƙira a cikin kayan daban-daban.Samfuran ingantattun samfura (wanda aka buga ta amfani da abubuwa da yawa na launuka daban-daban da laushi don kwafi kwafin halayen tatsuniya na ƙirar cadaver) suna buƙatar ƙarin fasahar bugu na 3D da tsayin ƙira.Wannan zai ƙara yawan farashi mai mahimmanci.Ko da wane tsarin bugu ne aka zaɓa, zabar hanyar hoto mai dacewa shine mabuɗin nasarar 3DPAM.Mafi girman ƙudurin sararin samaniya, mafi kyawun ƙirar ƙirar ta zama kuma ana iya amfani da ita don bincike mai zurfi.Daga ra'ayi na ilmantarwa, 3DPAM kayan aiki ne mai tasiri don koyar da ilimin jiki, kamar yadda gwaje-gwajen ilimin da aka yi wa ɗalibai da kuma gamsuwa sun tabbatar.Tasirin koyarwa na 3DPAM ya fi kyau lokacin da ya sake haifar da hadaddun yankuna na jiki kuma ɗalibai suna amfani da shi da wuri a cikin horon likitancin su.
Rubutun bayanan da aka samar da/ko tantancewa a cikin binciken na yanzu ba a samuwa a bainar jama'a saboda shingen harshe amma ana samunsu daga mawallafin da ya dace akan buƙatun da ya dace.
Drake RL, Lowry DJ, Pruitt CM.Bita na babban jikin mutum, microanatomy, neurobiology, da darussan ilimin mahaifa a cikin manhajojin makarantun likitancin Amurka.Anat Rec.2002; 269 (2): 118-22.
Ghosh SK Cadaveric dissection azaman kayan aikin ilimi don kimiyyar jiki a cikin ƙarni na 21: Rarraba azaman kayan aikin ilimi.Nazarin ilimin kimiyya.2017;10 (3):286–99.
Lokacin aikawa: Afrilu-09-2024