腹腔镜基础技能模拟训练的量化研究  

A quantitative study about simulation training of basic laparoscopic surgical skills

作　　者：许锐锐 王鉴杰 陈耿臻 黄泽鸿 郑凯欣 韩慧 吴成亮 包业炜 Xu Ruirui;Wang Jianjie;Chen Gengzhen;Huang Zehong;Zheng Kaixin;Han Hui;Wu Chengliang;Bao Yewei(Minimally Invasive Medical Center,The Second Affiliated Hospital of Shantou Medical College,Shantou 515000,China;Shantou University Medical College,Shantou 515000,China)

机构地区：[1]汕头大学医学院第二附属医院微创医学中心,515000 [2]汕头大学医学院,515000

出　　处：《中华腔镜外科杂志（电子版）》2018年第5期300-305,共6页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：广东省医学科研基金立项课题(B2015047);汕头市科学技术局(58);汕头大学医学院临床研究提升计划项目(201408)

摘　　要：目的比较医学生和外科低年资住院医师在腹腔镜基础技能模拟训练中的差异,为腹腔镜基础技能训练提供客观的数据。方法通过比较医学生和低年资医师在传递、精确定位、剪切、打结及缝合打结项目中的操作时间和失误情况得分的差异,建立各自的学习曲线。结果经过10次训练后,A、B组参与者在传递、精确定位、剪切、打结及缝合打结5个项目的得分分别是(89. 81±2. 07) vs(93. 91±3. 46)、(89. 00±6. 39) vs (91. 21±6. 69)、(84. 35±5. 94) vs (86. 69±6. 46)、(93. 88±3. 01) vs(93. 51±2. 65)、(87. 34±3. 22) vs (92. 09±4. 10)。A、B组参与者的精确定位、剪切、打结的训练结果之间无差异(P> 0. 05),而传递和缝合打结的训练结果之间存在统计学差异(P <0. 05)。A、B组参与者在同一训练项目中第1次与第10次的训练结果之间存在差异(P <0. 05)。A、B组参与者在传递、打结和缝合打结项目中呈反曲线发展,而在精确定位和剪切两个项目中呈线性发展。结论通过训练,A、B组参与者的腹腔镜基础技能均获得显著提高,重复性的训练可以使A组在精确定位、剪切、打结的训练中达到B组的水平,A、B组参与者在传递、打结和缝合打结项目中已达到平台期,而在精确定位和剪切两个项目中仍处于增长期。Objective This study aimed to compare the difference between the performance of medical students and young residents during the laparoscopic simulation training in basic laparoscopic procedures, and providing objective data for simulation training in basic laparoscopic procedures. Methods By comparing the task completion time and errors of medical students and young residents on transferring, accurate positioning, cutting, knotting, suturing and knotting, and analysis of learning curves were done. Results After 10 times of training, the scores in the training tasks of transferring, accurate positioning, cutting, knotting, suturing and knotting in group A and group B were as follows： （89.81±2.07） vs （93.91± 3.46）, （89.00±6.39） vs（91.21±6.69）, （84.35±5.94）vs（86.69±6.46）, （93.88± 3.01） vs（93.51±2.65）, （87.34±3.22）vs （92.09±4.10）. No significant differences were observed between group A and group B in the training tasks of accurate positioning, cutting and knotting （ P 〉0.05）. However, significant statistical differences existed between group A and group B in the tasks of transferring and suturing and knotting （ P 〈0.05）. In learning curve, the performance of the participants from group A and group B demonstrated the form of inverse curve in the tasks of transferring, knotting, and suturing and knotting, while the performance of both groups linearly increased in the tasks of accurate positioning and cutting. Conclusions The basic laparoscopic skills of group A and group B improved significantly by means of simulation training. Through repetitive training, the performance of group A can reach the level of group B in the tasks of accurate positioning, cutting and knotting. Both groups had reached the plateau in the tasks of transferring, knotting, and suturing and knotting, whereas their performance was still in the growth stage in the tasks of accurate positioning and cutting.

关 键 词：腹腔镜基础技能 模拟训练 学习曲线 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]