日间手术模式下白内障手术集中分步式教学法的初步应用  

Preliminary application of a centralized step-by-step teaching method for cataract surgery in ambulatory surgery pattern

作　　者：谢海南 黄厚斌[1,2] Xie Hainan;Huang Houbin(Department of Ophthalmology,Hainan Hospital of PLA General Hospital,Sanya Hainan 572013,China;Senior Department of Ophthalmology,PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院海南医院眼科,海南三亚572013 [2]解放军总医院眼科医学部,北京100853

出　　处：《眼科》2025年第2期161-164,共4页Ophthalmology in China

基　　金：海南省重点研发计划高新技术项目(ZDYF2024GXJS032);军队后勤科研项目保健专项课题(23BJZ37);海南省卫生健康行业科研项目(22A200351)。

摘　　要：目的探索日间手术模式下超声乳化白内障手术集中分步式教学的效果。设计回顾性比较性研究。研究对象解放军总医院海南医院接受培训年轻医师15人,其中2014-2017年接受传统培训模式5人(第一组),2018-2023年接受集中分步培训模式10人(第二组)。方法第一组医师负责患者全程临床沟通、病历管理及手术治疗。第二组医师分理论培训及手术技能培训两个阶段。两组培训全程在带教老师指导下完成白内障手术。培训后均独立主刀常规白内障手术3个月。比较两组间培训效果及体验的差异。主要指标常规白内障手术时间、手术并发症发生率和培训体验李克特评分。结果第一组医师和第二组医师在培训结束后3个月内独立完成常规白内障手术分别为141眼、287眼;平均手术并发症发生率分别为11.35%和6.62%,两组比较有统计学差异(χ2=3.92,P=0.04);平均一台手术时间分别为(2215±857)秒、(1743±608)秒,两组比较无统计学差异(t=6.54,P=1.67)。李克特量表的评分,两组医师术前理解手术步骤无差异(P=0.075),但第二组医师对容易掌握白内障手术(P=0.001)、术中心理负担小(P=0.003)、对学习曲线满意(P=0.001)的评分均高于第一组。结论集中分步教学模式有效提高眼科年轻医师的超声乳化白内障手术水平,且充分保证手术安全性和有效性。Objective To explore the effectiveness of a centralized step-by-step teaching method for cataract surgery under ambulatory surgery pattern.Design Retrospective comparative study.Participants Fifteen young trainee doctors from Hainan Hospital of the PLA General Hospital were included.Among them,five received the traditional training model from 2014 to 2017(Group 1),and ten received the centralized step-by-step training model after its reform from 2018 to 2023(Group 2).Methods In the traditional training model,doctors were responsible for comprehensive patient communication,medical record management,and surgical treatment.The centralized training model was divided into two phases:theoretical training and surgical skill training.The entire training process was completed under the guidance of the instructor for cataract surgery.After training,doctors from both groups independently performed routine cataract surgeries for three months.The training outcomes and experiences of the two groups were compared.Main Outcome Measures Operation time and incidence of complications in cataract surgery and training experience assessed using the Likert-type scale.Results Within three months post-training,the doctors of Group 1 independently completed 141 eyes of routine cataract surgeries,with an average complication rate of 11.35%.In contrast,the ten doctors of Group 2 independently completed 287 eyes of cataract surgeries,with an average complication rate of 6.62%.The difference in complication rates between the two groups was statistically significant(χ2=3.92,P=0.04).The average duration of a single surgery was(2215±857)seconds for the Group 1 and(1743±608)seconds for the Group 2,with no statistically significant difference between the two groups(t=6.54,P=1.67).According to the Likert scale,there was no significant difference in the understanding of surgical steps before training between the two groups(P=0.075).However,the scored of Group 2 higher in ease of mastering cataract surgery(P=0.001),reduced psychological burden dur

关 键 词：教学 白内障/外科学 

分 类 号：R47[医药卫生—护理学]