手把手培训后ERCP工作开展情况的影响因素分析  

Influencing factors for the performance of trainees after hands-on training of endoscopic retrograde cholangiopancreatography

作　　者：张荣春[1] 潘阳林[1] 陶芹[1] 刘志国[1] 罗辉[1] 王向平[1] 王飙落[1] 梁树辉[1] 孙安华[1] 郭学刚[1] 

机构地区：[1]第四军医大学西京消化病医院,西安710032

出　　处：《中华医学杂志》2015年第16期1245-1247,共3页National Medical Journal of China

摘　　要：目的 调查经内镜胰胆管造影术（ERCP）手把手培训后受训医生返院后的ERCP开展情况,并分析相关影响因素.方法 对2008年1月至2013年5月在西京消化病医院内镜中心进行ERCP培训的46名医生进行问卷调查,比较分析不同受训时间、受训期间操作例数、所处医疗机构条件等因素对学员后续ERCP工作开展情况的影响.结果 共回收有效问卷41份（89.1％）.其中34人来自三甲医院（82.9％）.平均受训时间为8.9个月.41人中每月开展ERCP例数＜4的医生23人,例数≥4的医生18人.与开展ERCP例数少（＜4例/月）的医生相比,开展较多ERCP（≥4例/月）的医生所处医疗机构从事ERCP的医生人数更多[2（2-3）比1（1-2）人,P=0.005],拥有十二指肠镜≥2条的比例、学员自我估计的插管成功率≥90.0％的比例和使用针状刀预切开的比例更高（均P＜0.05）.学员自我评估认为影响培训后ERCP开展的最主要3个因素是分别：医院的支持、个人操作能力和病例数量.结论 学员受训后能否良好开展ERCP工作受诸多因素影响,包括受训后个人的操作能力、科室和医院的支持等.Objective To evaluate the performance of trainees after finishing hands-on training of endoscopic retrograde cholangiopancreatography （ERCP） at our hospital.Methods Questionnaire was distributed to 46 trainees of ERCP training over the past 5 years.And the effects of training duration,case volume and hospital facilities on ERCP performance were examined.Results A total of 41 valid questionnaires （89.1%） were retrieved.And 34 trainees （82.9%） worked at tertiary medical centers.The mean training duration was 8.9 months.Compared with trainees with less annual ERCP volume （TL） （〈4cases per month,n =23）,trainees with more volume （TM） （≥4 cases per month,n =18） had a higher rate of successful cannulation and precut by a needle knife （both P 〈 0.05）.More endoscopists could perform ERCP and more duodenoscopes were stocked at hospitals of TM compared with TL （both P 〈 0.05）.The results of trainee self-evaluation showed that the major influencing factors of post-training ERCP performance were hospital supports,handling capacity and case volume.Conclusion After hands-on training,the trainee performance of ERCP is influenced by such multiple factors as handling capacity and hospital supports,etc.

关 键 词：内窥镜检查 消化系统 胰胆管造影术 内窥镜逆行 培训 

分 类 号：R192[医药卫生—卫生事业管理]