"进阶式单人肠镜培训法"在进修医师内镜初级培训中的应用  

Application of"upgraded single-entry colonoscope training method"in the primary endoscopic training of refresher doctors

作　　者：曲玉虎[1] 闵丛丛 毛涛[2] 刘华[2] 尹晓燕[2] 李晓宇[2] Qu Yuhu;Min Congcong;Mao Tao;Liu Hua;Yin Xiaoyan;Li Xiaoyu

机构地区：[1]青岛大学附属医院消化内科,青岛266003山东省慢性病医院(山东省康复中心)内镜中心,青岛266000 [2]青岛大学附属医院消化内科,青岛266003

出　　处：《中华医学教育探索杂志》2022年第9期1240-1243,共4页Chinese Journal of Medical Education Research

基　　金：山东省高等教育研究中心科研规划课题(YJKT201953)山东省研究生教育质量提升计划(SDYJG21110)

摘　　要：目的探讨"进阶式单人肠镜培训法"在进修医师内镜初级培训中的教学效果。方法选择2017年1月至2019年12月在青岛大学附属医院消化内镜中心参加初级单人肠镜培训的进修医师共71名作为研究对象。将其分为"进阶式单人肠镜培训组"(36人)和"传统单人肠镜培训组"(35人)。第1周,入选者学习单人肠镜进镜的基本理论。第2~11周,两组学员每人练习80~100例肠镜,其中"进阶式单人肠镜培训组"分"直肠-乙状结肠近段""降结肠-回盲部"两个阶段进行进阶式培训,区别于传统组。第12周进行考核,每人考核单人肠镜操作各20例,比较两组肠镜的插入回盲部的成功率、通过乙状结肠时间、结袢率、成功插入回盲部的平均操作时间等指标。应用SPSS 26.0行t检验或卡方检验。结果"进阶式单人肠镜培训组"与"传统单人肠镜培训组"相比,在插入回盲部的成功率(66.8%vs.59.0%,P=0.005)、通过乙状结肠时间[(6.05±3.32)min vs.(7.15±3.12)min,P<0.001]、结袢率(35.13%vs.40.71%,P=0.035)、成功插入回盲部的平均操作时间[(9.01±2.12)min vs.(10.25±3.12)min,P<0.001]及受检者的不适反应评分[(5.19±1.41)vs.(6.70±2.15),P<0.001]方面成绩更加优异,组间差异有统计学意义。结论"进阶式单人肠镜培训法"更利于进修医师掌握单人肠镜操作技巧,缩短教学时间,减轻患者不适反应,适宜推广教学。Objective To explore the application of"upgraded single-entry colonoscope training method"in the primary endoscopic training of refresher doctors.Methods A total of 71 refresher doctors who participated in the primary single endoscopy training in the Endoscopy Center of the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were randomized to two groups:upgraded single-entry endoscopy training group(n=36)and traditional single-entry endoscopy training group(n=35).In the first week of training,all the participants learned the basic theory of single-entry enteroscopy insertion.From week 2 to week 11,each doctors of the two groups finally completed 80 to 100 cases of single-entry endoscopy.The upgraded single-entry colonoscopy training group was divided into two stages:"rectum-proximal sigmoid colon"and"descending colon-ileocecal part"with the boundary of descending-sigmoid colon as the dividing point,which was different from the traditional group.At the 12th week,each doctors were assessed by 20 cases of single-entry colonoscopy operation.the success rate of ileocecum insertion,the time to pass through sigmoid colon,the rate of loop formation and the average operation time of successful ileocecum insertion were compared between the two groups.SPSS 26.0 was used for t test or chi-square test.Results Compared with the traditional single-entry endoscopy training group,the upgraded single-entry endoscopy training group achieved better results in the successful rate of ileocecal insertion(66.8%vs.59.0%,P=0.005),the time to pass sigmoid colon[(6.05±3.32)min vs.(7.15±3.12)min,P<0.001],the loop rate(35.13%vs.40.71%,P=0.035),the average operation time of successfully inserting the ileocecal part[(9.01±2.12)min vs.(10.25±3.12)min,P<0.001]and the discomfort response score[(5.19±1.41)vs.(6.70±2.15),P<0.001],with statistical significance between the groups.Conclusion"Upgraded single-entry endoscopy training method"emphasizes no loop through sigmoid colon,which is more helpful for refresher doctor

关 键 词：进阶式培训法 内镜初级培训 单人肠镜插入法 进修医师 

分 类 号：R47[医药卫生—护理学]