摘要
目的构建全皮下植入型心律转复除颤器(S-ICD)植入的学习曲线。方法分析2018年12月至2021年10月于新疆医科大学第一附属医院由单一术者连续植入S-ICD的患者资料, 将病例按手术先后编号, 评估手术时间变化, 并利用累计和分析法(CUSUM方法)构建学习曲线, 分析曲线达峰所需例数。结果共纳入由单一术者完成的64例患者, 年龄(57.00±14.81)岁, 年龄范围为11~85岁, 其中男49例(76.56%, 49/64)。手术时间随例数增加呈下降趋势, 手术时间从前32例患者的54.03 min减少到后32例患者的40.72 min。对CUSUM进行拟合曲线分析后, 拟合方程:CUSUM(n)=44.35+27.28n+(-0.911 8n^(2))+0.011 22n^(3)+(-0.000 046 23n^(4))(n为手术例数), 在第23例时拟合曲线达到顶点。对非肥胖患者进行亚组分析显示, 拟合方程:CUSUM(n)=56.02+20.08n+(-0.849 7n^(2))+(0.008 783n^(3))(n为手术例数), CUSUM拟合曲线在第17例时即达到顶点。结论术者可以通过较少病例掌握S-ICD植入技术, 肥胖是手术时间的重要影响因素。
Objective To construct a learning curve for total subcutaneous implantable cardioverter defibrillator(S-ICD)implantation.Methods To analyze the data of 64 consecutive patients implanted with S-ICD by a single operator in The First Affiliated Hospital of Xinjiang Medical University from December 2018 to October 2021.The patients were numbered according to the order of operation.The changes in operation time were evaluated,and a learning curve was constructed using the accumulative sum analysis method(CUSUM method)to analyze the number of cases required to reach the peak of the curve.Results A total of 64 patients in the age range of 11-85 years were included,of whom 49(76.56%,49/64)were male.The operative time tended to decrease with the increasing number of cases,and the mean operative time decreased from 54.03 minutes in the first 32 patients to 40.72 minutes in the second 32 patients.After analyzing the fitting curve for CUSUM,the fitted equation was:CUSUM(n)=44.35+27.28n+(-0.9118n^(2))+0.01122n^(3)+(-0.00004623n^(4))(n was the number of surgical cases),and the fitted curve reached its peak at the 23rd case.Subgroup analysis of non-obese patients showed that the fitted equation was CUSUM(n)=56.02+20.08n+(-0.8497n^(2))+(0.008783n^(3))(n was the number of surgical cases),and the CUSUM fitted curve reached its peak at 17th case.Conclusion Operators can master the S-ICD implantation technique with fewer cases,and obesity is an important factor affecting the operative time.
作者
董震宇
穆耶赛尔·玉苏普
芦颜美
李耀东
周贤惠
汤宝鹏
Dong Zhenyu;Muyassar·Yusup;Lu Yanmei;Li Yaodong;Zhou Xianhui;Tang Baopeng(Department of Pacing and Electrophysiology,Department of Cardiac Electrophysiology and Remodeling,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中华心律失常学杂志》
2023年第2期125-129,共5页
Chinese Journal of Cardiac Arrhythmias
基金
国家重点专项精准医学项目(2016YFC0900905)。
关键词
心力衰竭
全皮下植入型心律转复除颤器
心脏性猝死
预防
学习曲线
Heart failure
Subcutaneous implantable cardioverter defibrillator
Sudden cardiac death
Prophylaxis
Learning curve
