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三孔法腹腔镜阑尾切除术相关学习曲线研究
吴亚东      朱春林      奚维伟
安徽省滁州市第一人民医院普外科,安徽滁州   239000
Investigation of learning curve for the three-port laparoscopic appendectomy  #br#
WU Yadong   ZHU Chunlin   XI Weiwei
Department General Surgery, Chuzhou First People’s Hospital, Anhui Province, Chuzhou   239000, China
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摘要 目的 研究三孔法腔镜阑尾切除术(LA)相关学习曲线。 方法 回顾性分析2018年8月至2020年7月安徽省滁州市第一人民医院普外科同一名主治医师首次开展并连续独立实施LA的72例急性阑尾炎患者的临床资料。根据中位手术时间将72例患者分为手术时间较长组(37例)及手术时间较短组(35例)。采用单因素分析比较影响手术时间的相关因素,将单因素分析中P < 0.05的相关因素纳入logistic回归分析,计算影响手术时间的因素。采用移动平均组线及方差分析检验计算LA学习曲线进入平台期的截断值。 结果 logistic回归分析结果证实手术熟练程度、患者体重指数是影响手术时间的最终危险因素。移动平均组线及方差分析检验计算发现三孔法腹腔镜阑尾切除术相关学习曲线约为48例。 结论 对于首次独立开展LA的临床医师初期可以选择病程短,体型偏瘦的患者,有助于降低手术难度,快速跨越学习曲线。
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吴亚东 朱春林 奚维伟
关键词 腹腔镜阑尾切除术学习曲线急性阑尾炎危险因素截断值    
Abstract:Objective To investigate the related learning curve and of the three-port laparoscopic appendectomy (LA). Methods A retrospective analysis was performed on the clinical data of 72 patients with acute appendicitis who underwent LA independently for the first time and continuously by the same attending physician in the Department of General Surgery of Chuzhou First People’s Hospital of Anhui Province from August 2018 to July 2020. According to the median operation time, 72 patients were divided into longer operation time group (37 cases) and shorter operation time group (35 cases). Univariate analysis was used to compare the factors influencing the operation time, and the factors with P < 0.05 in univariate analysis were included in logistic regression analysis to calculate the factors influencing the operation time. The truncation value of LA learning curve was calculated by means of moving average line and analysis of variance test. Results Logistic regression analysis confirmed that surgical proficiency and body mass index were the final risk factors affecting the duration of surgery. The results showed that the learning curve of three-hole LA was about 48 cases. Conclusion For the surgeon who firstly perform LA independently, patients chosen with a small body wass index and short course can help reduce the difficulty of surgery and quickly cross the learning curve.
Key wordsLaparoscopic appendectomy    Learning curve;Acute appendicitis;Risk factors;Cut-off value
    
基金资助:安徽省卫生和计划生育委员会科研计划项目(2016QKD16)。
引用本文:   
吴亚东 朱春林 奚维伟. 三孔法腹腔镜阑尾切除术相关学习曲线研究[J]. 中国医药导报, 2021, 18(31): 104-107.
WU Yadong ZHU Chunlin XI Weiwei. Investigation of learning curve for the three-port laparoscopic appendectomy  #br#. 中国医药导报, 2021, 18(31): 104-107.
链接本文:  
https://www.yiyaodaobao.com.cn/CN/     或     https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I31/104

 

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