腹腔镜下全子宫切除术学习曲线分析
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摘要
目的分析腹腔镜下全子宫切除术同一团队不同阶段的手术效果,探讨腹腔镜下全子宫切除术的学习曲线。方法回顾性分析2015年8月～2017年8月承德医学院附属医院妇科由同一术者连续开展的最初80例腹腔镜下全子宫切除术病例,按照住院开展手术时间的先后顺序分为A、B、C、D组,每组20例。比较各阶段手术时间、术者出血量、术后住院日及并发症发生情况,分析不同阶段手术效果的差异。结果 A组手术时间长于其余各组,术中出血量高于其余各组,差异具有统计学意义(P<0.05),但B、C、D组比较,差异无统计学意义(P>0.05);4组间术后住院日及并发症发生情况比较,差异无统计学意义(P>0.05)。结论腹腔镜全子宫切除手术经过约20例能达到平稳的状态。
Objective To analyze the surgical outcomes of different stages of laparoscopic hysterectomy in the same team and to explore the learning curve of laparoscopic hysterectomy. Methods A retrospective analysis of the first 80 cases of laparoscopic hysterectomy performed continuously by the same surgeon from August 2015 to August 2017 in the Department of Gynecology, Affiliated Hospital of Chengde Medical College, according to the order of hospitalization, was divided into A, B, C, and D, 20 cases in each group. The operation time, the amount of blood loss, the postoperative hospital stay and complications were compared at each stage, and the differences in surgical outcomes at different stages were analyzed. Results The operation time of group A was longer than that of the other groups. The intraoperative blood loss was higher than the other groups,the difference was statistically significant(P<0.05), but there was no significant difference between groups B, C and D(P>0.05). There was no significant difference in postoperative hospitalization days and complications between the 4 groups(P>0.05).Conclusion Laparoscopic hysterectomy can achieve a stable state after about 20 cases.
Objective To analyze the surgical outcomes of different stages of laparoscopic hysterectomy in the same team and to explore the learning curve of laparoscopic hysterectomy. Methods A retrospective analysis of the first 80 cases of laparoscopic hysterectomy performed continuously by the same surgeon from August 2015 to August 2017 in the Department of Gynecology, Affiliated Hospital of Chengde Medical College, according to the order of hospitalization, was divided into A, B, C, and D, 20 cases in each group. The operation time, the amount of blood loss, the postoperative hospital stay and complications were compared at each stage, and the differences in surgical outcomes at different stages were analyzed. Results The operation time of group A was longer than that of the other groups. The intraoperative blood loss was higher than the other groups,the difference was statistically significant(P<0.05), but there was no significant difference between groups B, C and D(P>0.05). There was no significant difference in postoperative hospitalization days and complications between the 4 groups(P>0.05).Conclusion Laparoscopic hysterectomy can achieve a stable state after about 20 cases.
引文
[1]刘彦.实用妇科腹腔镜手术学[M].北京:科学技术文献出版社,2014:196-206.
[2]Kong TW,Chang SJ,Paek J,et al.Learning curve analysis of laparoscopic radical hysterectomy for gynecologic oncologists without open counterpart experience[J].Obstetrics&Gynecology Science,2015,58(5):377-384.
[3]王红.腹腔镜全子宫切除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国计划生育和妇产科,2016,8(5):58-61.
[4]冯伟伟,施浩帆,苏妍,等.阴式全子宫切除术和腹腔镜下全子宫切除术的临床对比分析[J].现代生物医学进展,2016,16(13):2472-2474.
[5]牛凝,王赛莉,唐珊玲,等.经腹和经阴道腹腔镜辅助的全子宫切除术临床分析[J].现代中西医结合杂志,2014,23(11):1180-1182.
[6]Jung DH,Son SY,Park YS,et al.Learning curve associated with laparoscopic total gastrectomy[J].Gastric Cancer,2016,19(1):264-272.
[7]蒋燕,赵卫东,周虎.腹腔镜联合杯状举宫器下全子宫切除术的学习曲线[J].安徽医学,2014,35(8):1023-1026.
[8]倪骎骎.腹腔镜下全子宫切除术效果及对患者生活质量影响分析[J].中国计划生育学杂志,2015,23(3):201-202.
[2]Kong TW,Chang SJ,Paek J,et al.Learning curve analysis of laparoscopic radical hysterectomy for gynecologic oncologists without open counterpart experience[J].Obstetrics&Gynecology Science,2015,58(5):377-384.
[3]王红.腹腔镜全子宫切除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国计划生育和妇产科,2016,8(5):58-61.
[4]冯伟伟,施浩帆,苏妍,等.阴式全子宫切除术和腹腔镜下全子宫切除术的临床对比分析[J].现代生物医学进展,2016,16(13):2472-2474.
[5]牛凝,王赛莉,唐珊玲,等.经腹和经阴道腹腔镜辅助的全子宫切除术临床分析[J].现代中西医结合杂志,2014,23(11):1180-1182.
[6]Jung DH,Son SY,Park YS,et al.Learning curve associated with laparoscopic total gastrectomy[J].Gastric Cancer,2016,19(1):264-272.
[7]蒋燕,赵卫东,周虎.腹腔镜联合杯状举宫器下全子宫切除术的学习曲线[J].安徽医学,2014,35(8):1023-1026.
[8]倪骎骎.腹腔镜下全子宫切除术效果及对患者生活质量影响分析[J].中国计划生育学杂志,2015,23(3):201-202.