操作频度对超声消融子宫肌瘤学习曲线的影响

发布时间：2018-02-02 08:40

本文关键词： 超声高强聚焦子宫肿瘤学习曲线操作频度　出处：《中国介入影像与治疗学》2015年12期 　论文类型：期刊论文

【摘要】：目的探讨医生操作频度对超声消融子宫肌瘤学习曲线的影响。方法回顾性分析2名已完成超声消融培训的医生(A医生、B医生)分别在各自单位初始独立开展41例(A组)及39例(B组)超声消融治疗的患者资料。采用累积求和法(CUSUM)评估2组的学习曲线。比较2名医生的操作频度是否对学习曲线存在影响。结果 A组手术室时间和手术时间明显长于B组(P0.05);两组患者子宫肌瘤消融率差异无统计学意义(P0.05),平均每月完成操作A医生为2例、B医生为7例。A医生CUSUM曲线在可接受失败率(H0)和不可接受失败率(H1)之间波动,从23例开始出现下降趋势,但未跨过H0。B医生CUSUM曲线呈现连续下降趋势,在13例时曲线跨过H0。结论操作频度是学习曲线的重要评价指标。超声消融治疗子宫肌瘤有着严格、复杂的程序,连续的操作实践是迅速完成学习曲线的必要前提。
[Abstract]:Objective to investigate the effect of frequency of operation on the learning curve of ultrasonic ablation of uterine leiomyoma. Methods two doctors who had completed ultrasonic ablation training were analyzed retrospectively. Clinical data of 41 patients in group A (n = 41) and 39 patients in group B (n = 39) treated with ultrasound ablation in their respective units, respectively. CUSUM (cumulative summation method) was used. To evaluate the learning curve of two groups and to compare whether the frequency of operation of two doctors affected the learning curve. Results the operating room time and operation time in group A were significantly longer than those in group B (P 0.05). There was no significant difference in the ablation rate of uterine leiomyoma between the two groups. The CUSUM curve of doctor B. A fluctuated between acceptable failure rate (H _ 0) and unacceptable failure rate (H _ 1), and began to decrease in 23 cases. However, the CUSUM curve of Dr. H0.B did not cross the curve and showed a continuous downward trend. Conclusion the frequency of operation is an important index of the learning curve. Ultrasound ablation has a strict and complex procedure for the treatment of uterine leiomyoma. Continuous practice is a necessary prerequisite for the rapid completion of the learning curve.
【作者单位】：重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地-重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室;重庆医科大学附属第一医院超声消融治疗中心;
【基金】：“十二五”国家科技支撑计划项目(2011BAI14B01) 973项目(2011CB707900)
【分类号】：R737.33
【正文快照】： 表1患者一般资料比较组别年龄(岁)BMI(kg/m2)肌瘤类型(例)肌瘤最大径(cm)肌瘤体积(cm3)前壁后壁侧壁宫底A组(n=41)39.9±5.3 22.48±4.41 18 10 10 3 5.85±1.72 96.24±83.34B组(n=39)40.5±5.9 23.58±2.65 23 9 5 2 5.89±1.41 90.68±65.73t/χ2值-0.424-1.349 2.481-0.12

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