进口与国产腹腔镜设备与器械下活体动物实验训练效果比较  

Training effect comparison of animal experiments under the imported and domestic laparoscopic equipments and instruments

作　　者：甘露[1] 张红[1] 林伶[1] 张奥雪 龚连生[1] 

机构地区：[1]中南大学湘雅医院,湖南长沙410008

出　　处：《中国内镜杂志》2015年第5期459-464,共6页China Journal of Endoscopy

基　　金：国家科技支撑计划(No:2013BAI17B03)基层内镜设备应用评价研究

摘　　要：目的探讨临床医师和临床医学学生在进口与国产腹腔镜下进行猪胆囊切除术的操作效果以及影响手术效果的因素。方法选择20名来自湘雅医院不同科室的临床医师和医学学生(硕士和博士)随机分为两组,使用进口和国产器械完成腹腔镜下猪胆囊切除术,基于手术时间、擦镜次数和剥离胆囊时间等考核参数进行加权平均值的计算,运用统计学软件进行多因素方差分析。结果进口组的手术时长(44.400±23.945)min少于国产组(50.100±29.388)min(P=0.622)。进口镜搭配国产器械的手术时长(46.700±33.263)min与进口组比较(P=0.842)。国产镜搭配进口器械的手术时长(34.800±9.531)min与国产组比较(P=0.191),组内及组间的手术时长差异无显著性(P>0.05)。不同腹腔镜的擦镜次数差异无显著性(P>0.05)。影响手术时长的显著因素是电凝钩剥离胆囊的时间。结论日本奥林巴斯公司生产的腹腔镜的防雾效果与国产天松牌腹腔镜之间差异无显著性,术者使用奥林巴斯与浙江桐庐的器械进行腹腔镜下猪胆囊切除术结果差异无显著性。在手术技能操作上应注重剥离胆囊与夹闭胆囊管的训练,从而使手术效果达到最佳。[Objective] To investigate the effects of operation and influencing factors of imported and domestic laparoscopes for eholecysteetomy in pigs for clinicians and clinical medical students. [ Methods ] The 20 clinicians and clinical undergraduate students from different departments of Xiangya hospital （MA, phD） were randomly divided into two groups and the imported and domestic equipments were used to complete laparoscopic cholecystectomy in pigs, the time in surgery, frequency of cleaning endoscope, time in isolating gallbladder and other weighted parameters were compared using statistical software draw significant difference. [ Results ] The operation time of the imported group （44.40±23.945） rain was less than the operation time of the domestic group （50.10±29.388） min （P =0.622）. The operation time of the imported laparoseope with domestic equipment （46.70±33.263） was compared with operation time of the imported group （P =0.842）. The operation time of the domestic laparoscope with imported equipment （34.80±9.531） min was compared with operation time of the domestic group （P =0.191）, the operation time differences of the inter-group and intra-group were not statistically significant （P 〉0.05）. Frequency of cleaning endoscope in different laparoscopies were not statistically significant difference （P 〉0.05）. The significant factor of influencing operation time was the time in free gallbladder bed with electric coagulation hook. [ Conclusion ] The laparoscopic antifog effects between laparoscope （Olympus Corp, Japan） and laparoseope （Tiansong, Zhejiang） were not statistically significant difference （P 〉0.05）. The surgeon used instruments （Olvmous. Colo. Janan） and instruments （Tonalu, Zhejiang） for laparoscopic cholecystectomy in pigs, the results of surgery were no significantly difference. We should pay attention to training of isolating the gallbladder and cliping cystic duct during operation, so that we could achieve the best operation resul

关 键 词：腹腔镜器械 腹腔镜胆囊切除术 手术效果 内镜训练 

分 类 号：R192[医药卫生—卫生事业管理]