摘要
为了探索临床先进技术推广模式，对“腹腔镜微创手术治疗结直肠癌”这一成熟技术进行普及与推广，摸索建立一整套培训体系。选择培训点组成手术团队、集中讲学、手术观摩、国内外进修，技术支持等系列方式，以学习曲线趋于稳定为标准，以手术时间、术中出血、术中副损伤、中转开腹率和1年原位复发率5项手术指标作为判定标准，进行培训组与对照组比较。以手术例数来判断学习者学习曲线趋于稳定，培训组在该项手术零起点的情况下达到学习曲线稳定分别需要13．8士0．75例、14．0±0．89例、10．2士0．74例、16．4±0．49例和20．4±0．49例；而对照组则分别需要28．6±1．69例、29．2±1．16例、27．8±0．74例、22．8i0．40例和25．4±1．03例。学习曲线趋于稳定所需时间，培训组分别需要13．4±1．02月、14．2±1．02月、14．2±1．32月、13．4±1．42月和17．2±0．98月；而对照组分别需要27．8±2．13月、28．0±1．67月、27．8±1．32月、22．4士1．20月和19．8±0．98月。在技术操作和技能熟练方面，专题培训组团培训明显优于普通进修的效果。
In order to find out appropriate model to best disseminate laparoscopy for colorectal cancer clinical advanced technologies,it is necessary to establish a whole set of training system, which included selecting training site , intensive training, operation observation, advanced study at home and abroad, technical support, etc.. Evaluation was based on operation time, hemorrhage in surgery , other injuries in surgery, conversion to open surgery and the ratio of in situ relapse in one year post surgery. These five indexes were compared between the training group and the control group with the gradually stable trend of learning curve as standard. Without previous laparoscopic surgery experience, the training group required 13.8±0.75, 14±0.89, 10.2±0.74, 16.4±0.49 and 20.4±0.49 cases, respectively, to achieve expected proficiency,and the control group required 28.6±1.69, 29.2±1.16, 27.8±0.74, 22.8 ± 0.40 and 25.4 ± 1.03 cases, respectively. The learning time required 13.4±1.02 months on average for the training group and 27.8 ± 2.13 months for the control group. In conclusion, the training system achieved obvious superiority to the controls to achieve expected skills and proficiency in laparoscopy for colorectal cancer.
出处
《中华医学科研管理杂志》
2013年第2期94-98,共5页
Chinese Journal of Medical Science Research Management
基金
科技部国际合作司国际科技合作与交流专项科研课题（2013DFA3150）
关键词
腹腔镜
直肠肿瘤
技术培训
人才培养
技术推广
Laparoscope
Rectal cancer
Technical training
Personnel training
Popularizing
techniques
