Ko ngā tauira hanganga tinana e toru-ahu ana (3DPAM) te āhua nei he taputapu pai nā te mea he uara mātauranga, he whaihua hoki. Ko te kaupapa o tēnei arotake he whakaahua me te tātari i ngā tikanga i whakamahia hei waihanga i te 3DPAM mō te whakaako i te hanganga tinana tangata, me te aromatawai i tana takoha whakaako.
I whakahaerehia he rapu hiko i roto i te PubMed mā te whakamahi i ēnei kupu: mātauranga, kura, ako, whakaako, whakangungu, whakaako, mātauranga, toru-ahu, 3D, 3-ahu, tā, tā, tā, hanganga tinana, hanganga tinana, hanganga tinana, me te hanganga tinana. . I roto i ngā kitenga ko ngā āhuatanga o te rangahau, te hoahoa tauira, te aromatawai āhua tinana, te whakatutukitanga mātauranga, ngā kaha me ngā ngoikoretanga.
I roto i ngā tuhinga 68 kua tīpakohia, ko te nuinga o ngā rangahau i aro ki te rohe angaanga (33 ngā tuhinga); 51 ngā tuhinga e kōrero ana mō te tānga wheua. I roto i ngā tuhinga 47, i whakawhanakehia te 3DPAM i runga i te tomography rorohiko. E rima ngā tukanga tā kua whakarārangihia. I whakamahia ngā kirihou me ōna pānga i roto i ngā rangahau 48. Ko te utu mō ia hoahoa kei waenga i te $1.25 ki te $2,800. E toru tekau mā whitu ngā rangahau i whakarite i te 3DPAM ki ngā tauira tohutoro. E toru tekau mā toru ngā tuhinga i tirotiro i ngā mahi mātauranga. Ko ngā painga matua ko te kounga tirohanga me te pā, te whai huatanga o te ako, te āheinga ki te whakahoki, te āheinga ki te whakarite me te tere, te penapena wā, te whakaurunga o te hanganga mahi, te pai ake o ngā āheinga hurihuri hinengaro, te pupuri mātauranga me te makona o te kaiako/ākonga. Ko ngā ngoikoretanga matua e pā ana ki te hoahoa: te ōrite, te kore o ngā taipitopito, te mārama rānei, ngā tae he kanapa rawa, te roa o te wā tā me te utu nui.
E whakaatu ana tēnei arotake pūnaha he iti te utu me te whai hua o te 3DPAM mō te whakaako i te hanganga tinana. Ko ngā tauira tino pono e hiahia ana ki te whakamahi i ngā hangarau tā 3D utu nui ake me ngā wā hoahoa roa ake, ka nui ake te utu whānui. Ko te mea nui ko te whiriwhiri i te tikanga whakaahua tika. Mai i te tirohanga whakaako, he taputapu whai hua te 3DPAM mō te whakaako i te hanganga tinana, me te pānga pai ki ngā putanga ako me te makona. Ka pai ake te pānga whakaako o te 3DPAM ina hangaia anōtia ngā rohe hanganga tinana uaua, ā, ka whakamahia e ngā ākonga i te tīmatanga o tā rātou whakangungu hauora.
Kua oti te mahi i te wetewete i ngā tinana kararehe mai i Kariki onamata, ā, ko tētahi o ngā tikanga matua mō te whakaako i te hanganga tinana. Ko ngā wetewete tūpāpaku e mahia ana i te wā whakangungu mahi ka whakamahia i roto i te marautanga ariā o ngā ākonga hauora o te whare wānanga, ā, e kiia ana i tēnei wā ko te paerewa koura mō te ako i te hanganga tinana [1,2,3,4,5]. Heoi, he maha ngā arai ki te whakamahinga o ngā tauira tūpāpaku tangata, e akiaki ana i te rapu taputapu whakangungu hou [6, 7]. Ko ētahi o ēnei taputapu hou ko te mooni whakanui, ngā taputapu matihiko, me te tā 3D. E ai ki tētahi arotake tuhinga hou nā Santos et al. [8] Mō te uara o ēnei hangarau hou mō te whakaako i te hanganga tinana, ko te tā 3D te āhua nei ko tētahi o ngā rauemi tino nui, e pā ana ki te uara mātauranga mō ngā ākonga me te whaihua o te whakatinanatanga [4,9,10].
Ehara i te mea hou te tānga 3D. Ko ngā mana pateni tuatahi e pā ana ki tēnei hangarau i ahu mai i te tau 1984: A Le Méhauté, O De Witte me JC André i Parani, ā, e toru wiki i muri mai ko C Hull i te USA. Mai i taua wā, kua whanake tonu te hangarau, ā, kua whānui haere tōna whakamahinga ki ngā wāhi maha. Hei tauira, i tāia e NASA te mea tuatahi i tua atu i te Ao i te tau 2014 [11]. Kua tangohia hoki e te ao hauora tēnei taputapu hou, ā, kua piki ake te hiahia ki te whakawhanake i te rongoā whaiaro [12].
He maha ngā kaituhi kua whakaatu i ngā painga o te whakamahi i ngā tauira hanganga tinana kua tāia 3D (3DPAM) i roto i te mātauranga hauora [10, 13, 14, 15, 16, 17, 18, 19]. I te wā e whakaako ana i te hanganga tinana o te tangata, me whakamahi i ngā tauira kore-mate me ngā tauira hanganga tinana noa. Kua tirohia e ētahi arotake ngā tauira whakangungu mate, hauora/pokanga rānei [8, 20, 21]. Hei whakawhanake i tētahi tauira ranu mō te whakaako i te hanganga tinana o te tangata e whakauru ana i ngā taputapu hou pēnei i te tānga 3D, i whakahaerehia e mātou he arotake pūnaha hei whakaahua me te tātari i te hanga o ngā mea kua tāia 3D hei whakaako i te hanganga tinana o te tangata, me te aromatawai a ngā ākonga i te whai huatanga o te ako mā te whakamahi i ēnei mea 3D.
I whakahaerehia tēnei arotake tuhinga pūnaha i te marama o Hune 2022, kāore he herenga wā, mā te whakamahi i ngā aratohu PRISMA (Ngā Tuemi Pūrongo Pai mō ngā Arotake Pūnaha me ngā Meta-Analyses) [22].
Ko ngā paearu whakauru ko ngā pepa rangahau katoa e whakamahi ana i te 3DPAM i roto i te whakaakoranga/akoranga anatomy. Kāore i whakaurua ngā arotake tuhinga, ngā reta, ngā tuhinga rānei e aro ana ki ngā tauira pathology, ngā tauira kararehe, ngā tauira archaeological, me ngā tauira whakangungu hauora/pokanga. Ko ngā tuhinga anake i whakaputaina i te reo Ingarihi i tīpakohia. Kāore i whakaurua ngā tuhinga kāore he whakarāpopototanga ipurangi e wātea ana. I whakaurua ngā tuhinga kei roto he maha ngā tauira, kotahi te iti rawa he noa te anatomy, he pathology iti rānei kāore e pā ki te uara whakaako.
I whakahaerehia he rapu tuhinga i roto i te pātengi raraunga hiko PubMed (National Library of Medicine, NCBI) hei tautuhi i ngā rangahau e tika ana i whakaputaina tae noa ki Hune 2022. Whakamahia ngā kupu rapu e whai ake nei: mātauranga, kura, whakaako, whakaako, ako, whakaako, mātauranga, toru-ahu, 3D, 3D, tānga, tānga, tānga, anatomy, anatomy, anatomy me te anatomy. Kotahi te uiui i whakahaerehia: (((education[Title/Abstract] OR school[Title/Abstract] ORlearning[Title/Abstract] OR teaching[Title/Abstract] OR training[Title/Abstract] OReach[Title/Abstract] ] OR Education [Title/Abstract]) AND (Three Dimensions [Title] OR 3D [Title] OR 3D [Title])) AND (Print [Title] OR Print [Title] OR Print [Title])) AND (Anatomy) [Title] ]/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract] anatomy [title/abstract]). I tautuhia ngā tuhinga tāpiri mā te rapu ā-ringa i te pātengi raraunga PubMed me te arotake i ngā tohutoro o ētahi atu tuhinga pūtaiao. Kāore i whakamahia he herenga rā, engari i whakamahia te tātari "Person".
I tirotirohia ngā taitara me ngā whakarāpopototanga katoa i kohia mai e ngā kaituhi e rua (EBR me AL), ā, ko ngā rangahau katoa kāore i tutuki i ngā paearu whakauru katoa i tangohia atu. I tangohia mai ngā whakaputanga tuhinga-katoa o ngā rangahau e toe ana, ā, i arotakehia e ngā kaituhi e toru (EBR, EBE me AL). Mēnā e tika ana, i whakatauhia ngā whakahē i roto i te kōwhiringa o ngā tuhinga e te tangata tuawhā (LT). Ko ngā whakaputanga i tutuki i ngā paearu whakauru katoa i whakaurua ki tēnei arotake.
I whakahaerehia te tango raraunga takitahi e ngā kaituhi e rua (EBR me AL) i raro i te tirotiro a tētahi atu kaituhi (LT).
- Ngā raraunga hoahoa tauira: ngā rohe hanganga tinana, ngā wāhanga hanganga tinana motuhake, te tauira tuatahi mō te tānga 3D, te tikanga hopu, te pūmanawa wehewehe me te whakatauira, te momo pūreretā 3D, te momo me te rahinga rauemi, te tauine tā, te tae, te utu tā.
- Aromatawai ā-tinana o ngā tauira: ngā tauira e whakamahia ana hei whakatairite, aromatawai hauora o ngā tohunga/kaiako, te maha o ngā kaiaromatawai, te momo aromatawai.
- Te whakaako i te tauira 3D: te aromatawai i te mōhiotanga o ngā ākonga, te tikanga aromatawai, te tokomaha o ngā ākonga, te tokomaha o ngā rōpū whakatairite, te whakarōpūtanga matapōkere o ngā ākonga, te mātauranga/momo ākonga.
E 418 ngā rangahau i kitea i roto i te MEDLINE, ā, e 139 ngā tuhinga i tangohia e te tātari "tangata". Whai muri i te arotake i ngā taitara me ngā whakarāpopototanga, e 103 ngā rangahau i tīpakohia mō te pānui tuhinga katoa. E 34 ngā tuhinga i tangohia nā te mea he tauira mate (9 ngā tuhinga), he tauira whakangungu hauora/pokanga (4 ngā tuhinga), he tauira kararehe (4 ngā tuhinga), he tauira irahiko 3D (1 te tuhinga) ehara rānei i te tuhinga pūtaiao taketake (16 ngā upoko). E 68 katoa ngā tuhinga i whakaurua ki te arotake. E whakaatu ana te Pikitia 1 i te tukanga whiriwhiri hei tūtohi rere.
He tūtohi rere e whakarāpopoto ana i te tautuhi, te tirotiro, me te whakaurunga o ngā tuhinga ki tēnei arotake pūnaha
I whakaputaina ngā rangahau katoa i waenga i te tau 2014 me te tau 2022, me te tau whakaputanga toharite o te tau 2019. I roto i ngā tuhinga 68 i whakaurua, 33 (49%) ngā rangahau he whakaahua me te whakamātautau, 17 (25%) he whakamātautau noa iho, ā, 18 (26%) he whakamātautau. He whakaahua noa iho. I roto i ngā rangahau whakamātautau 50 (73%), 21 (31%) i whakamahi i te matapōkere. 34 noa iho ngā rangahau (50%) i whakauru i ngā tātaritanga tatauranga. E whakarāpopoto ana te Ripanga 1 i ngā āhuatanga o ia rangahau.
E 33 ngā tuhinga (48%) i tirotiro i te rohe o te mahunga, e 19 ngā tuhinga (28%) i tirotiro i te rohe o te uma, e 17 ngā tuhinga (25%) i tirotiro i te rohe o te puku, ā, e 15 ngā tuhinga (22%) i tirotiro i ngā pito. E rima tekau mā tahi ngā tuhinga (75%) i whakahua i ngā wheua tānga-3D hei tauira hanganga tinana, hei tauira hanganga tinana maha-poro rānei.
Mō ngā tauira pūtake, ngā kōnae rānei i whakamahia hei whakawhanake i te 3DPAM, e 23 ngā tuhinga (34%) i whakahua i te whakamahinga o ngā raraunga tūroro, e 20 ngā tuhinga (29%) i whakahua i te whakamahinga o ngā raraunga tūpāpaku, ā, e 17 ngā tuhinga (25%) i whakahua i te whakamahinga o ngā pātengi raraunga. i whakamahia, ā, e 7 ngā rangahau (10%) kāore i whakaatu i te pūtake o ngā tuhinga i whakamahia.
E 47 ngā rangahau (69%) i whakawhanake i te 3DPAM i runga i te rorohiko tomografia, ā, e 3 ngā rangahau (4%) i kōrero mō te whakamahinga o te microCT. E 7 ngā tuhinga (10%) i whakaata i ngā mea 3D mā te whakamahi i ngā matawai whatu, e 4 ngā tuhinga (6%) mā te whakamahi i te MRI, ā, kotahi te tuhinga (1%) mā te whakamahi i ngā kāmera me ngā karu hiko. Kāore i whakahuatia te pūtake o ngā kōnae pūtake hoahoa tauira 3D e 14 (21%). Ka hangaia ngā kōnae 3D me te taumira ā-wāhi toharite iti iho i te 0.5 mm. Ko te taumira tino pai ko te 30 μm [80] ā, ko te taumira mōrahi ko te 1.5 mm [32].
E ono tekau ngā tono pūmanawa rerekē (te wehewehe, te whakatauira, te hoahoa, te tā rānei) i whakamahia. Ko te Mimics (Materialise, Leuven, Belgium) te mea i whakamahia pinepinetia (14 ngā rangahau, 21%), ā, i muri mai ko MeshMixer (Autodesk, San Rafael, CA) (13 ngā rangahau, 19%), Geomagic (3D System, MO, NC, Leesville). (10 ngā rangahau, 15%), 3D Slicer (Slicer Developer Training, Boston, MA) (9 ngā rangahau, 13%), Blender (Blender Foundation, Amsterdam, Netherlands) (8 ngā rangahau, 12%) me CURA (Geldemarsen, Netherlands) (7 ngā rangahau, 10%).
E ono tekau mā whitu ngā tauira pūreretā rerekē me ngā tukanga tā e rima kua whakahuatia. I whakamahia te hangarau FDM (Fused Deposition Modeling) i roto i te 26 hua (38%), te pupuhi rauemi i roto i te 13 hua (19%), ā, i te mutunga ko te pupuhi here (11 hua, 16%). Ko ngā hangarau iti rawa te whakamahinga ko te stereolithography (SLA) (5 ngā tuhinga, 7%) me te selective laser sintering (SLS) (4 ngā tuhinga, 6%). Ko te pūreretā e whakamahia whānuitia ana (7 ngā tuhinga, 10%) ko te Connex 500 (Stratasys, Rehovot, Iharaira) [27, 30, 32, 36, 45, 62, 65].
I te wā i tohua ai ngā rauemi i whakamahia hei hanga i te 3DPAM (51 ngā tuhinga, 75%), 48 ngā rangahau (71%) i whakamahi i ngā kirihou me ō rātou hua. Ko ngā rauemi matua i whakamahia ko te PLA (waikawa polylactic) (n = 20, 29%), te kapia (n = 9, 13%) me te ABS (acrylonitrile butadiene styrene) (7 ngā momo, 10%). 23 ngā tuhinga (34%) i tirotiro i te 3DPAM i hangaia mai i ngā rauemi maha, 36 ngā tuhinga (53%) i whakaatu i te 3DPAM i hangaia mai i te rauemi kotahi anake, ā, 9 ngā tuhinga (13%) kāore i tohua he rauemi.
E rua tekau mā iwa ngā tuhinga (43%) i kōrero mō ngā ōwehenga tānga mai i te 0.25:1 ki te 2:1, me te toharite o te 1:1. E rua tekau mā rima ngā tuhinga (37%) i whakamahi i te ōwehenga 1:1. E 28 ngā 3DPAM (41%) he maha ngā tae, ā, e 9 (13%) i taehia i muri i te tānga [43, 46, 49, 54, 58, 59, 65, 69, 75].
E toru tekau mā whā ngā tuhinga (50%) i kōrero mō ngā utu. E iwa ngā tuhinga (13%) i kōrero mō te utu o ngā pūreretā 3D me ngā rauemi mata. Ko te utu mō ngā pūreretā kei waenganui i te $302 ki te $65,000. Ina tohua, ko ngā utu mō ngā tauira kei waenganui i te $1.25 ki te $2,800; ko ēnei tauira tino rerekē e pā ana ki ngā tauira angaanga [47] me ngā tauira retroperitoneal tino pono [48]. E whakarāpopoto ana te Ripanga 2 i ngā raraunga tauira mō ia rangahau kua whakaurua.
E toru tekau mā whitu ngā rangahau (54%) i whakarite i te 3DAPM ki tētahi tauira tohutoro. I roto i ēnei rangahau, ko te whakataurite tino noa ko tētahi tauira tohutoro anatomical, i whakamahia i roto i ngā tuhinga 14 (38%), ngā whakaritenga plastinated i roto i ngā tuhinga 6 (16%), ngā whakaritenga plastinated i roto i ngā tuhinga 6 (16%). Te whakamahinga o te mooni mariko, te whakaahua tomography rorohiko i tētahi 3DPAM i roto i ngā tuhinga 5 (14%), tētahi atu 3DPAM i roto i ngā tuhinga 3 (8%), ngā kēmu nui i roto i te tuhinga 1 (3%), ngā x-ray i roto i te tuhinga 1 (3%), ngā tauira pakihi i roto i te tuhinga 1 (3%) me te mooni whakanui i roto i te tuhinga 1 (3%). E toru tekau mā whā (50%) ngā rangahau i arotake i te 3DPAM. Tekau mā rima (48%) ngā rangahau i whakaahua taipitopito i ngā wheako o ngā kaitātari (Ripanga 3). I whakahaerehia te 3DPAM e ngā taote pokanga, e ngā tākuta rānei e haere mai ana i roto i ngā rangahau e 7 (47%), ngā tohunga tinana i roto i ngā rangahau e 6 (40%), ngā ākonga i roto i ngā rangahau e 3 (20%), ngā kaiako (kāore i te whakahuatia te kaupapa) i roto i ngā rangahau e 3 (20%) mō te aromatawai me tētahi atu kaiaromatawai i roto i te tuhinga (7%). Ko te toharite o ngā kaiaromatawai he 14 (iti rawa 2, mōrahi 30). E toru tekau mā toru ngā rangahau (49%) i aromatawai i te āhua o te 3DPAM mā te kounga, ā, e 10 ngā rangahau (15%) i aromatawai i te āhua o te 3DPAM mā te rahinga. O ngā rangahau e 33 i whakamahi i ngā aromatawai kounga, e 16 i whakamahi i ngā aromatawai whakaahua noa (48%), e 9 i whakamahi i ngā whakamātautau/whakatauranga/rangahau (27%), ā, e 8 i whakamahi i ngā tauine Likert (24%). E whakarāpopoto ana te Ripanga 3 i ngā aromatawai āhua o ngā tauira i roto i ia rangahau i whakaurua.
E toru tekau mā toru (48%) ngā tuhinga i arotake, i whakarite hoki i te whai huatanga o te whakaako i te 3DPAM ki ngā ākonga. O ēnei rangahau, e rua tekau mā toru (70%) ngā tuhinga i aromatawai i te pai o ngā ākonga, e whitu tekau mā whitu (51%) i whakamahi i ngā tauine Likert, ā, e ono (18%) i whakamahi i ētahi atu tikanga. E rua tekau mā rua ngā tuhinga (67%) i aromatawai i te ako a ngā ākonga mā te whakamātautau mātauranga, e tekau mā rua (30%) o ēnei i whakamahi i ngā whakamātautau o mua me/ranei ngā whakamātautau o muri. Tekau mā tahi ngā rangahau (33%) i whakamahi i ngā pātai me ngā whakamātautau whiriwhiri maha hei aromatawai i te mātauranga o ngā ākonga, ā, e rima ngā rangahau (15%) i whakamahi i te tapanga whakaahua/te tautuhi tinana. I te toharite o te whitu tekau mā ono ngā ākonga i whai wāhi ki ia rangahau (iti rawa 8, mōrahi 319). E rua tekau mā whā ngā rangahau (72%) he rōpū whakahaere, ā, e rua tekau (60%) o ēnei i whakamahi i te matapōkere. He rerekē, kotahi te rangahau (3%) i tohatoha matapōkere i ngā tauira tinana ki te tekau ngā ākonga rerekē. I te toharite, e rua tekau mā ono ngā rōpū i whakaritea (iti rawa 2, mōrahi 10). E rua tekau mā toru ngā rangahau (70%) i uru atu ki ngā tauira hauora, ā, 14 (42%) o ēnei he tauira hauora tau tuatahi. E ono (18%) ngā rangahau i uru atu ki ngā tāngata noho, e 4 (12%) ngā tauira niho, me te 3 (9%) ngā tauira pūtaiao. E ono ngā rangahau (18%) i whakatinana me te aromatawai i te ako motuhake mā te whakamahi i te 3DPAM. E whakarāpopoto ana te Ripanga 4 i ngā hua o te aromatawai whai huatanga whakaako 3DPAM mō ia rangahau i whakaurua.
Ko ngā painga matua i kōrerotia e ngā kaituhi mō te whakamahi i te 3DPAM hei taputapu whakaako mō te hanganga tinana o te tangata ko ngā āhuatanga tirohanga me ngā āhuatanga pā, tae atu ki te tūturutanga [55, 67], te tika [44, 50, 72, 85], me te rerekētanga ōritetanga [34, 45]. , 48, 64], tae me te māramatanga [28, 45], pakari [24, 56, 73], pānga mātauranga [16, 32, 35, 39, 52, 57, 63, 69, 79], utu [27, 41, 44, 45, 48, 51, 60, 64, 80, 81, 83], āheinga ki te tāruarua [80], te āheinga ki te whakapai ake, ki te whakawhaiaro rānei [28, 30, 36, 45, 48, 51, 53, 59, 61, 67 , 80], te kaha ki te whakahaere i ngā ākonga [30, 49], te penapena wā whakaako [61, 80], te ngāwari o te rokiroki [61], te kaha ki te whakauru i te hanganga mahi, ki te waihanga rānei i ngā hanganga motuhake [51, 53], 67], te hoahoa tere o ngā tauira angaanga [81], te kaha ki te waihanga tahi ngā tauira me te kawe ki te kāinga [49, 60, 71], te whakapai ake i ngā pūkenga hurihuri hinengaro [23] me te pupuri mātauranga [32], tae atu ki te kaiako [25, 63] me te makona o ngā ākonga [25, 45, 46, 52, 52, 57, 63, 66, 69, 84].
Ko ngā ngoikoretanga matua e pā ana ki te hoahoa: te pakari [80], te ōritetanga [28, 62], te kore o ngā taipitopito, te kore rānei o te māramatanga [28, 30, 34, 45, 48, 62, 64, 81], te kanapa rawa o ngā tae [45]. me te pakarukaru o te papa [71]. Ko ētahi atu ngoikoretanga ko te ngaronga o ngā mōhiohio [30, 76], te roa o te wā e hiahiatia ana mō te wehewehenga whakaahua [36, 52, 57, 58, 74], te wā tā [57, 63, 66, 67], te kore o te rerekētanga o te tinana [25], me te utu. Teitei [48].
E whakarāpopoto ana tēnei arotake pūnaha i ngā tuhinga 68 i whakaputaina mō ngā tau 9, ā, e whakaatu ana i te hiahia o te hapori pūtaiao ki te 3DPAM hei taputapu mō te whakaako i te hanganga tinana o te tangata. I akohia ia rohe hanganga tinana, ā, i tāia ki te 3D. O ēnei tuhinga, e 37 ngā tuhinga i whakarite i te 3DPAM ki ētahi atu tauira, ā, e 33 ngā tuhinga i aromatawai i te hiranga o te 3DPAM ki ngā ākonga.
I runga i ngā rerekētanga o te hoahoa o ngā rangahau tānga 3D tinana, kāore mātou i whakaaro he mea tika kia whakahaerehia he tātaritanga-maha. Ko tētahi tātaritanga-maha i whakaputaina i te tau 2020 i aro nui ki ngā whakamātautau mōhiotanga tinana i muri i te whakangungu, me te kore e tātari i ngā āhuatanga hangarau me te hangarau o te hoahoa me te whakaputa 3DPAM [10].
Ko te rohe o te upoko te mea tino rangahauhia, nā te uaua pea o tōna hanganga tinana ka uaua ake mā ngā ākonga te whakaatu i tēnei rohe hanganga tinana i roto i te wāhi toru-ahu ki te whakataurite ki ngā peka, ki te tinana rānei. Ko te CT te momo whakaahua e whakamahia whānuitia ana. He whānuitia te whakamahinga o tēnei tikanga, inā koa i roto i ngā wāhi hauora, engari he iti te taumira ā-wāhi me te iti o te rerekētanga kiko ngohengohe. Nā ēnei herenga ka kore e pai ngā karapa CT mō te wehewehe me te whakatauira i te pūnaha io. I tētahi atu taha, he pai ake te tomography rorohiko mō te wehewehe/tauira kiko wheua; ka āwhina te rerekētanga wheua/kiko ngohengohe ki te whakaoti i ēnei mahi i mua i te tā 3D i ngā tauira hanganga tinana. I tētahi atu taha, e kiia ana ko te microCT te hangarau tohutoro mō te taumira ā-wāhi i roto i te whakaahua wheua [70]. Ka taea hoki te whakamahi i ngā matawai whatu, MRI rānei hei tiki whakaahua. Ka ārai te taumira teitei ake i te whakangawari o ngā mata wheua, ā, ka tiakina te mātotoru o ngā hanganga hanganga tinana [59]. Ka pā hoki te whiriwhiri tauira ki te taumira ā-wāhi: hei tauira, he iti ake te taumira o ngā tauira kirihou [45]. Me hanga e ngā kaihoahoa whakairoiro ngā tauira 3D ritenga, ka piki ake ngā utu ($25 ki te $150 ia hāora) [43]. Kāore e ranea te whiwhi i ngā kōnae .STL kounga teitei hei hanga i ngā tauira hanganga tinana kounga teitei. He mea tika kia whakatauhia ngā tawhā tā, pērā i te whakatakotoranga o te tauira hanganga tinana i runga i te pereti tā [29]. E kī ana ētahi kaituhi me whakamahi ngā hangarau tā matatau pērā i te SLS i ngā wāhi katoa e taea ai hei whakapai ake i te tika o te 3DPAM [38]. Me āwhina ngaio te hanga o te 3DPAM; ko ngā tohunga e tino rapuhia ana ko ngā miihini [72], ngā tohunga hihi-X, [75], ngā kaihoahoa whakairoiro [43] me ngā tohunga hanganga tinana [25, 28, 51, 57, 76, 77].
He mea nui te whakawāhanga me te pūmanawa whakatauira hei whiwhi i ngā tauira hanganga tinana tika, engari ko te utu o ēnei kete pūmanawa me tōna uauatanga ka ārai i te whakamahinga. He maha ngā rangahau kua whakataurite i te whakamahinga o ngā kete pūmanawa me ngā hangarau tā rerekē, e whakaatu ana i ngā painga me ngā ngoikoretanga o ia hangarau [68]. Haunga te pūmanawa whakatauira, me whai pūmanawa tā hototahi ki te pūreretā kua tīpakohia; he pai ake ki ētahi kaituhi te whakamahi i te tā 3D tuihono [75]. Mena he nui ngā mea 3D e tāia ana, ka taea e te haumi te arahi ki ngā hokinga moni [72].
Ko te kirihou te rauemi e whakamahia whānuitia ana. Nā te whānuitanga o ngā kakano me ngā tae, koinei te rauemi e pai ana mō te 3DPAM. Kua whakanuia e ētahi kaituhi tōna kaha teitei ki te whakataurite ki ngā tauira tuku iho o te tinana mate, o te kirihou rānei [24, 56, 73]. He āhuatanga piko, he āhuatanga totoro rānei ētahi kirihou. Hei tauira, ka taea e Filaflex me te hangarau FDM te totoro ki te 700%. E whakaaro ana ētahi kaituhi koinei te rauemi e pai ana mō te tāruarua o te uaua, te uaua me te hononga [63]. I tētahi atu taha, e rua ngā rangahau kua whakaara ake i ngā pātai mō te whakatakotoranga muka i te wā tā. Inaa, he mea nui te whakatakotoranga muka uaua, te whakaurunga, te whakaroto, me te mahi i roto i te whakatauira uaua [33].
He mea whakamiharo, he iti noa ngā rangahau e kōrero ana mō te tauine o te tānga. Nā te mea he tokomaha te hunga e whakaaro ana ko te ōwehenga 1:1 he paerewa, kāore pea te kaituhi i kōrero mōna. Ahakoa he pai te whakanui ake i te tauine mō te ako ā-ringa i roto i ngā rōpū nui, kāore anō kia tūhuratia te whaihua o te whakanui ake, inā koa me te tipu haere o ngā rahi akomanga me te rahi tinana o te tauira he mea nui. Ko te tikanga, mā ngā tauine rahi tonu ka māmā ake te kimi me te whakawhitiwhiti i ngā āhuatanga tinana ki te tūroro, ā, koinei pea te take e whakamahia pinepinetia ai.
O ngā pūreretā maha e wātea ana i te mākete, ko ngā mea e whakamahi ana i te hangarau PolyJet (waituhi rauemi, waituhi here rānei) hei whakarato i te tae me te tānga maha-paparanga (ā, nō reira, maha-kano) he utu kei waenganui i te US$20,000 me te US$250,000 (https: //www.aniwaa.com/). Tērā pea ka whakawhāitihia e tēnei utu nui te whakatairanga i te 3DPAM i roto i ngā kura hauora. Haunga te utu o te pūreretā, he nui ake te utu o ngā rauemi e hiahiatia ana mō te tānga waituhi i ngā pūreretā SLA, FDM rānei [68]. He iti ake te utu mō ngā pūreretā SLA, FDM rānei, mai i te €576 ki te €4,999 i roto i ngā tuhinga kua whakarārangihia i roto i tēnei arotake. E ai ki a Tripodi mā, ka taea te tā i ia wāhanga angaanga mō te US$1.25 [47]. Tekau mā tahi ngā rangahau i whakatau he iti ake te utu o te tānga 3D i te kirihou, i ngā tauira arumoni rānei [24, 27, 41, 44, 45, 48, 51, 60, 63, 80, 81, 83]. Heoi anō, kua hangaia ēnei tauira arumoni hei whakarato i ngā mōhiohio mō ngā tūroro, engari kāore e ranea ngā taipitopito mō te whakaakoranga anatomy [80]. E kiia ana ēnei tauira arumoni he iti iho i te 3DPAM [44]. He mea tika kia mōhiotia, hei tāpiri atu ki te hangarau tā e whakamahia ana, ko te utu whakamutunga he rite ki te tauine, nō reira ko te rahi whakamutunga o te 3DPAM [48]. Mō ēnei take, ko te tauine rahi tonu te mea e pai ake ana [37].
Kotahi anake te rangahau i whakarite i te 3DPAM ki ngā tauira anatomical e wātea ana i te hokohoko [72]. Ko ngā tauira tūpāpaku te mea e whakamahia whānuitia ana mō te 3DPAM. Ahakoa ō rātou herenga, he taputapu nui tonu ngā tauira tūpāpaku mō te whakaako i te anatomical. Me wehewehe i waenga i te tātaritanga tupapaku, te tapahi me te wheua maroke. I runga i ngā whakamātautau whakangungu, e rua ngā rangahau i whakaatu he nui ake te whai huatanga o te 3DPAM i te tapahi plastinated [16, 27]. I whakaritea e tētahi rangahau te kotahi hāora o te whakangungu mā te whakamahi i te 3DPAM (pito o raro) me te kotahi hāora o te tapahi o te rohe anatomical kotahi [78]. Kāore he rerekētanga nui i waenga i ngā tikanga whakaako e rua. He iti pea te rangahau mō tēnei kaupapa nā te mea he uaua ki te mahi i aua whakataurite. He roa te wā e pau ana i ngā ākonga ki te whakarite. I ētahi wā e hiahiatia ana he maha ngā hāora o te whakarite, i runga i te mea e whakaritea ana. Ka taea te whakarite tuatoru ki ngā wheua maroke. I kitea i roto i tētahi rangahau a Tsai rāua ko Smith he pai ake ngā kaute whakamātautau i roto i te rōpū e whakamahi ana i te 3DPAM [51, 63]. I kite a Chen mā i te pai ake o te mahi a ngā ākonga e whakamahi ana i ngā tauira 3D ki te tautuhi i ngā hanganga (angaanga), engari kāore he rerekētanga i roto i ngā kaute MCQ [69]. Hei whakamutunga, i whakaatu a Tanner mā i ngā hua pai ake i muri i te whakamātautau i roto i tēnei rōpū mā te whakamahi i te 3DPAM o te pterygopalatine fossa [46]. I kitea ētahi atu taputapu whakaako hou i roto i tēnei arotake tuhinga. Ko ngā mea tino noa i roto i ēnei ko te mooni whakanuia, te mooni mariko me ngā kēmu nui [43]. E ai ki a Mahrous mā, ko te pai ake ki ngā tauira anatomical e whakawhirinaki ana ki te maha o ngā hāora e takaro ana ngā ākonga i ngā kēmu ataata [31]. I tētahi atu taha, ko te ngoikoretanga nui o ngā taputapu whakaako anatomical hou ko te urupare haptic, inā koa mō ngā taputapu mariko noa iho [48].
Ko te nuinga o ngā rangahau e arotake ana i te 3DPAM hou kua whakamahi i ngā whakamātautau o mua mō te mātauranga. Ka āwhina ēnei whakamātautau ki te karo i te whakaaro pōhēhē i roto i te aromatawai. Ko ētahi kaituhi, i mua i te whakahaere i ngā rangahau whakamātautau, ka whakakore i ngā ākonga katoa i whiwhi i te tohu i runga ake i te toharite i te whakamātautau tuatahi [40]. I roto i ngā whakaaro pōhēhē i whakahuatia e Garas mā ko te tae o te tauira me te kōwhiringa o ngā tūao i roto i te akomanga ākonga [61]. Mā te tae ka taea te tautuhi i ngā hanganga tinana. I whakatūria e Chen mā ko ngā tikanga whakamātautau tino pakari me te kore he rerekētanga tuatahi i waenga i ngā rōpū, ā, i matapohia te rangahau ki te taumata teitei rawa atu [69]. E taunaki ana a Lim mā ko ngā hoa mahi kia whakaotihia te aromatawai i muri i te whakamātautau e tētahi rōpū tuatoru hei karo i te whakaaro pōhēhē i roto i te aromatawai [16]. Kua whakamahia e ētahi rangahau ngā tauine Likert hei aromatawai i te whaihua o te 3DPAM. He pai tēnei taputapu mō te aromatawai i te makona, engari kei reira tonu ngā whakaaro pōhēhē nui hei mōhio [86].
I arotakehia te hiranga o te 3DPAM ki te mātauranga i waenga i ngā ākonga hauora, tae atu ki ngā ākonga hauora tau tuatahi, i roto i te 14 o ngā rangahau 33. I roto i tā rātou rangahau whakamātautau, i kōrero a Wilk mā i whakapono ngā ākonga hauora me whakauru te tānga 3D ki roto i ā rātou akoranga anatomy [87]. 87% o ngā ākonga i uiuitia i roto i te rangahau a Cercenelli i whakapono ko te tau tuarua o te rangahau te wā pai ki te whakamahi i te 3DPAM [84]. I whakaatu anō hoki ngā hua a Tanner mā i pai ake te mahi a ngā ākonga mēnā kāore rātou i ako i tēnei mara [46]. E kī ana ēnei raraunga ko te tau tuatahi o te kura hauora te wā pai ki te whakauru i te 3DPAM ki roto i te whakaakoranga anatomy. I tautokohia tēnei whakaaro e te tātaritanga-maha a Ye [18]. I roto i ngā tuhinga 27 i whakaurua ki roto i te rangahau, he rerekētanga nui kei roto i ngā kaute whakamātautau i waenga i te 3DPAM me ngā tauira tuku iho mō ngā ākonga hauora, engari kāore mō ngā kainoho.
Mā te 3DPAM hei taputapu ako ka whakapai ake i te whakatutukitanga mātauranga [16, 35, 39, 52, 57, 63, 69, 79], te pupuri mātauranga mō te wā roa [32], me te makona o ngā ākonga [25, 45, 46, 52, 57, 63, 66]. , 69 , 84]. I kitea hoki e ngā rōpū tohunga he whai hua ēnei tauira [37, 42, 49, 81, 82], ā, e rua ngā rangahau i kitea te makona o ngā kaiako ki te 3DPAM [25, 63]. O ngā puna katoa, e whakaaro ana a Backhouse me ōna hoa mahi ko te tā 3D te huarahi pai rawa atu ki ngā tauira hanganga tinana tuku iho [49]. I roto i tā rātou tātaritanga tuatahi, i whakaū a Ye me ōna hoa mahi he pai ake ngā kaute whakamātautau-muri o ngā ākonga i whiwhi tohutohu 3DPAM i ngā ākonga i whiwhi tohutohu 2D, i ngā tohutohu tūpāpaku rānei [10]. Heoi, i wehewehea e rātou te 3DPAM ehara i te mea nā te uaua, engari nā te ngākau, te pūnaha io, me te kōhao puku. I roto i ngā rangahau e whitu, kāore te 3DPAM i eke ki runga ake i ētahi atu tauira i runga i ngā whakamātautau mātauranga i tukuna ki ngā ākonga [32, 66, 69, 77, 78, 84]. I roto i tā rātou tātaritanga-maha, i whakatau a Salazar mā ko te whakamahinga o te 3DPAM ka whakapai ake i te māramatanga ki te hanganga uaua [17]. He rite tonu tēnei ariā ki te reta a Hitas ki te ētita [88]. Ko ētahi wāhi hanganga e kiia ana he iti ake te uaua kāore e hiahiatia te whakamahinga o te 3DPAM, engari ko ngā wāhi hanganga uaua ake (pērā i te kaki, i te pūnaha io rānei) he kōwhiringa arorau mō te 3DPAM. Tērā pea ka whakamāramahia e tēnei ariā he aha ētahi 3DPAM kāore i te kiia he pai ake i ngā tauira tuku iho, inā koa ka kore ngā ākonga e mōhio ki te mara e kitea ana he pai ake te mahi tauira. Nō reira, ko te whakaatu i tētahi tauira māmā ki ngā ākonga kua mōhio kē ki te kaupapa (ngā ākonga hauora, ngā ākonga noho rānei) kāore e āwhina ki te whakapai ake i te mahi a ngā ākonga.
O ngā painga mātauranga katoa kua whakarārangihia, 11 ngā rangahau i whakanui i ngā āhuatanga tirohanga, pā rānei o ngā tauira [27,34,44,45,48,50,55,63,67,72,85], ā, 3 ngā rangahau i whakapai ake i te kaha me te roa (33, 50 -52, 63, 79, 85, 86). Ko ētahi atu painga ko te taea e ngā ākonga te whakahaere i ngā hanganga, ka taea e ngā kaiako te penapena wā, he māmā ake te tiaki i ngā tūpāpaku, ka taea te whakaoti i te kaupapa i roto i ngā hāora 24, ka taea te whakamahi hei taputapu ako kāinga, ā, ka taea te whakamahi hei whakaako i te nui o ngā mōhiohio. [30, 49, 60, 61, 80, 81]. Mā te tā 3D anō mō te whakaakoranga anatomy nui-rahi ka nui ake te utu o ngā tauira tā 3D [26]. Mā te whakamahinga o te 3DPAM ka taea te whakapai ake i ngā āheinga hurihuri hinengaro [23] me te whakapai ake i te whakamaoritanga o ngā whakaahua whakawhiti-wāhanga [23, 32]. E rua ngā rangahau i kitea ai he nui ake te tūponotanga o te pokanga ki ngā ākonga i pangia e te 3DPAM [40, 74]. Ka taea te whakauru i ngā hononga whakarewa hei hanga i te nekehanga e hiahiatia ana hei ako i te hanganga mahi [51, 53], ka taea rānei te tā i ngā tauira mā te whakamahi i ngā hoahoa whakaoho [67].
Mā te tānga 3D ka taea te hanga tauira hanganga tinana whakarerekē mā te whakapai ake i ētahi āhuatanga i te wā whakatauira, [48, 80] te hanga i tētahi turanga e tika ana, [59] te whakakotahi i ngā tauira maha, [36] te whakamahi i te mārama, (49) te tae, [45] te whakaatu rānei i ētahi hanganga o roto [30]. I whakamahia e Tripodi mā te uku whakairo hei tāpiri i ā rātou tauira wheua tānga 3D, me te whakanui i te uara o ngā tauira i hangaia tahitia hei taputapu whakaako [47]. I roto i ngā rangahau e 9, i whakamahia te tae i muri i te tānga [43, 46, 49, 54, 58, 59, 65, 69, 75], engari kotahi noa te wā i whakamahia ai e ngā ākonga [49]. Engari, kāore te rangahau i aromatawai i te kounga o te whakangungu tauira, i te raupapa whakangungu rānei. Me whakaaro tēnei i roto i te horopaki o te mātauranga hanganga tinana, nā te mea kua tino whakapumautia ngā painga o te ako whakakotahi me te hanga tahi [89]. Hei whakatau i te tipu haere o ngā mahi pānuitanga, kua maha ngā wā i whakamahia ai te ako-whaiaro hei aromatawai i ngā tauira [24, 26, 27, 32, 46, 69, 82].
I roto i tētahi rangahau i whakatauhia he kanapa rawa te tae o te rauemi kirihou[45], i whakatauhia e tētahi atu rangahau he pakarukaru rawa te tauira[71], ā, e rua atu rangahau i whakaatu i te kore o te rerekētanga o te hanganga tinana i roto i te hoahoa o ia tauira[25, 45]. E whitu ngā rangahau i whakatau kāore i te rawaka ngā taipitopito hanganga tinana o te 3DPAM [28, 34, 45, 48, 62, 63, 81].
Mō ngā tauira anatomical taipitopito ake o ngā rohe nui me te uaua, pērā i te retroperitoneum, te tuaiwi cervical rānei, e kiia ana he roa rawa te wā wehewehe me te whakatauira, ā, he tino nui te utu (tata ki te US$2000) [27, 48]. I kī a Hojo mā i roto i tā rātou rangahau e 40 hāora te roa ki te waihanga i te tauira anatomical o te pelvis [42]. Ko te wā wehewehe roa rawa atu ko te 380 hāora i roto i tētahi rangahau a Weatherall mā, i whakakotahihia ai ngā tauira maha hei waihanga i tētahi tauira ara manawa tamariki katoa [36]. I roto i ngā rangahau e iwa, i kiia te wā wehewehe me te tā he ngoikoretanga [36, 42, 57, 58, 74]. Heoi, 12 ngā rangahau i whakahē i ngā āhuatanga ā-tinana o ā rātou tauira, inā koa ko tō rātou ōritetanga, [28, 62] te kore o te mārama, [30] te ngoikore me te kotahi te tae, [71] te kore o te kiko ngohengohe, [66] te kore rānei o te taipitopito [28, 34]. , 45, 48, 62, 63, 81]. Ka taea te whakakore i ēnei ngoikoretanga mā te whakanui ake i te wā wehewehe, te wā whakaata rānei. Ko te ngaronga me te tiki mai i ngā mōhiohio e tika ana he raruraru i pā ki ngā tīma e toru [30, 74, 77]. E ai ki ngā pūrongo a ngā tūroro, kāore i tino kitea ngā oko toto nā te iti o te horopeta i whakamahia ai te iodine [74]. Ko te werohanga o te tauira tūpāpaku te āhua nei he tikanga pai rawa atu e neke atu ana i te kaupapa "kia iti rawa" me ngā herenga o te horopeta o te oko toto i werohangahia.
Engari, he maha ngā tuhinga kāore i te whakahua i ētahi āhuatanga matua o te 3DPAM. Iti iho i te haurua o ngā tuhinga i kī mārama mēnā i pania te tae ki tā rātou 3DPAM. Kāore i te ōrite te whānuitanga o te tānga (43% o ngā tuhinga), ā, 34% anake i whakahua i te whakamahinga o ngā momo pāpāho. He mea nui ēnei tawhā tā nā te mea ka pā ki ngā āhuatanga ako o te 3DPAM. Ko te nuinga o ngā tuhinga kāore e whakarato i ngā mōhiohio e ranea ana mō ngā uauatanga o te whiwhi 3DPAM (te wā hoahoa, ngā tohu mātauranga kaimahi, ngā utu pūmanawa, ngā utu tā, me ētahi atu). He mea nui tēnei mōhiohio, ā, me whai whakaaro i mua i te whakaaro ki te tīmata i tētahi kaupapa hei whakawhanake i tētahi 3DPAM hou.
E whakaatu ana tēnei arotake pūnaha he mea taea te hoahoa me te tā 3D i ngā tauira hanganga tinana noa i te utu iti, inā koa ka whakamahia ngā pūreretā FDM, SLA rānei me ngā rauemi kirihou kotahi-tae iti te utu. Heoi, ka taea te whakapai ake i ēnei hoahoa taketake mā te tāpiri tae, te tāpiri rānei i ngā hoahoa ki ngā rauemi rerekē. Ko ngā tauira tino pono (e tāia ana mā te whakamahi i ngā rauemi maha o ngā tae me ngā kakano rerekē hei whakaata tata i ngā āhuatanga pā o te tauira tohutoro tūpāpaku) me nui ake te utu o ngā hangarau tā 3D me ngā wā hoahoa roa ake. Ka nui ake te utu o tēnei i te utu whānui. Ahakoa te tukanga tā e whiriwhiria ana, ko te whiriwhiri i te tikanga whakaahua tika te mea nui ki te angitu o te 3DPAM. Ko te teitei ake o te taumira ā-wāhi, ko te tino pono ake o te tauira, ā, ka taea te whakamahi mō ngā rangahau matatau. Mai i te tirohanga whakaako, he taputapu whai hua te 3DPAM mō te whakaako i te hanganga tinana, e whakaatuhia ana e ngā whakamātautau mōhiotanga e tukuna ana ki ngā ākonga me ō rātou makona. Ko te pānga whakaako o te 3DPAM he pai ake ina tāruatia e ia ngā rohe hanganga tinana uaua, ā, ka whakamahia e ngā ākonga i te tīmatanga o tā rātou whakangungu hauora.
Kāore ngā huinga raraunga i hangaia, i tātaritatia rānei i roto i te rangahau o nāianei e wātea ana ki te marea nā runga i ngā arai reo, engari e wātea ana mai i te kaituhi e pā ana mēnā he tono tika.
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Wā tuku: Paenga-whāwhā-09-2024