摘要
目的:利用数学模型拟合精确的胰腺节段切除术(CP)学习过程曲线,为更好地了解CP手术方式的练习过程提供参考。方法:通过收集中国医学科学院肿瘤医院胰胃外科同组医师在2006年1月至2018年1月期间施行的73例CP患者数据,按照时间排序标号。利用移动平均法(MAM)和累积求和法(CUSUM)精确分析学习曲线,并以SPSS统计软件对不同阶段的相关参数进行对比分析。结果:通过MAM和CUSUM拟合的学习曲线将CP分为2个阶段,第1阶段(1~11例)中位手术时间为340 min,中位术中出血量为400 ml;第2阶段(12~73例)中位手术时间为213 min,中位术中出血量为100 ml,差异均有统计学意义(均 P<0.001)。2个阶段患者一般资料和术后并发症的发生率差异均无统计学意义(均 P>0.05)。 结论:CP度过11例的学习阶段后效果趋于稳定。外科医师在前11例CP的学习过程中需要熟悉操作流程,积极应对突发事件,积累经验,才能更安全地度过学习阶段。
Objective To explore the learning curve of central pancreatectomy(CP)and provide an excellent reference for surgeons to get the point of this operation.Methods Clinical data of 73 patients who underwent CP in the same operation team from January 2006 to January 2018 were collected and retrospectively analyzed by the moving average method(MAM)and the cumulative sum method(CUSUM).Data was analyzed by statistical package for social science(SPSS)software.Results According to the MAM and CUSUM curves,the learning process of CP could be divided into two stages.At the first stage(n=1-11),the median operation time was 340 minutes and the median intraoperative hemorrhage was 400 ml.In the second stage(n=12-73),the median operation time was 213 minutes and the median intraoperative hemorrhage was 100 ml.The difference was statistically significant(P<0.001).There were no significant differences between the two stages of patients in terms of other aspects(P>0.05).Conclusions CP can be mastered after 11 cases of exercises.In the first 11 operations,surgeons should get familiar with the operation process,respond actively to emergencies and accumulate experience to gain this surgical technique fast.
作者
储云绵
邱国同
杜永星
兰忠民
张建伟
王成锋
Chu Yunmian;Qiu Guotong;Du Yongxing;Lan Zhongmin;Zhang Jianwei;Wang Chengfeng(Department of Pancreatic and Gastric Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2020年第12期1020-1024,共5页
Chinese Journal of Oncology
基金
中国医学科学院医学与健康科技创新工程(协同创新团队项目2016-I2M-1-001)。
关键词
胰腺肿瘤
胰腺节段切除术
学习曲线
并发症
Pancreatic neoplasms
Central pancreatectomy
Learning curve
Complications
