经支气管针吸活检术临床应用的学习曲线

发布时间：2018-04-17 05:03

  本文选题：气管镜 + 经支气管针吸活检术　； 参考：《中国内镜杂志》2017年04期

【摘要】：目的针对已熟练掌握支气管镜操作技能的呼吸内科医师,通过评估经支气管针吸活检术(TBNA)的穿刺时间和穿刺阳性率,探讨TBNA的学习曲线规律。方法选取2013年5月-2014年8月在该院支气管镜室最初连续开展的60例行TBNA检查患者的病例资料。按TBNA操作先后顺序依次分为4组(A、B、C和D),每组15例设为一操作学习阶段,每例均由同一位医师操作完成TBNA检查。比较各阶段的平均穿刺时间、穿刺阳性率及穿刺并发症。结果各组病例在性别、年龄等方面差异无统计学意义(P0.05)。A组(15.2±2.0)min和B组(14.7±2.2)min穿刺时间均长于C组(8.3±1.6)min和D组(7.6±1.3)min,且差异有统计学意义(P0.05),但A组和B组之间及C组和D组之间穿刺时间差异无统计学意义(P0.05);A组(26.7%)和B组(33.3%)穿刺阳性率均低于C组(80.0%)和D组(80.0%),且差异有统计学意义(P0.05),但A组和B组之间及C组和D组之间穿刺阳性率差异无统计学意义(P0.05);各组穿刺误入血管,穿刺后引起的穿刺点黏膜出血、气胸、纵隔血肿、纵隔出血及纵隔感染等并发症均无明显差异。结论对已熟练掌握支气管镜操作技能的呼吸内科医师,经支气管针吸活检术的学习曲线大约为30例。
[Abstract]:Objective to investigate the learning curve of TBNA by evaluating the puncture time and the positive rate of puncture for the respiratory physician who has mastered the skill of bronchoscopy.Methods from May 2013 to August 2014, 60 consecutive TBNA examinations were performed in the bronchoscope room of the hospital.According to the sequence of TBNA operation, the patients were divided into 4 groups in order, 15 cases in each group were set up as an operation learning stage, each case was performed TBNA examination by the same doctor.The average puncture time, puncture positive rate and puncture complications were compared.Results the cases in each group were sex,There was no significant difference in age between group A (15.2 卤2.0)min) and group B (14.7 卤2.2)min). The puncture time of group A was significantly longer than that of group C (8.3 卤1.6)min) and group D (7.6 卤1.3 min), but there was no significant difference in puncture time between group A and group B and between group C and group D.The positive rate of puncture in group A and group B was lower than that in group C (80.010) and group D (80.0), and the difference was statistically significant (P 0.05), but there was no significant difference between group A and group B and between group C and group D (P0.05), and there was no significant difference in puncture positive rate between group A and group B and between group C and group D, and there was no significant difference in puncture positive rate between group A and group B and between group C and group D, and there was no significant difference in puncture positive rate between group A and group B and between group C and group D;There was no significant difference in mucosal bleeding, pneumothorax, mediastinal hematoma, mediastinal hemorrhage and mediastinal infection.Conclusion for the respiratory physician who has mastered the skill of bronchoscopy, the learning curve of bronchus needle aspiration biopsy is about 30 cases.
【作者单位】： 安徽省芜湖市第二人民医院呼吸内科;
【分类号】：R768.1
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本文编号：1762167