不同年龄医生应用腹腔镜模拟训练器的效果分析

The Training Effects of Laparoscopic Simulation Training Device on Doctors of Different Ages

目的探讨不同年龄段医生参与腹腔镜模拟训练器的培训效果。方法按年龄分3组,每组10人,低龄组(年龄≤25岁)、中龄组(年龄>25～≤35岁)和大龄组(年龄>35～≤45岁)。训练内容为腹腔镜下夹取黄豆、剪切图形和缝合打结训练,分别在训练前、训练3次、训练6次记录1 min内的拾豆数,剪切一个几何图形所需的时间及10 min内的缝合打结数,各计数3次,取平均值。结果训练前3组夹取黄豆数分别为(9.2±1.7)、(10.2±1.2)、(9.0±1.4)个/min,无统计学差异(F=1.97,P=0.159),训练3次后低龄组1 min夹豆数(17.2±2.1)个/min明显多于中龄组(14.2±1.9)个/min(q=5.342,P<0.05)和大龄组(11.3±1.2)个/min(q=10.507,P<0.05),中龄组明显多于大龄组(q=5.164,P<0.05);训练6次后3组比较无统计学差异(F=2.27,P=0.123)。训练前3组剪裁几何图形所需时间分别为(11.2±1.6)、(10.2±1.2)、(10.2±1.2)min,无统计学差异(F=1.84,P=0.178),训练3次后低龄组剪裁几何图形所需时间(5.2±1.1)min明显少于中龄组(8.2±1.3)min(q=8.105,P<0.05)和大龄组(11.2±1.1)min(q=16.210,P<0.05),中龄组明显少于大龄组(q=8.105,P<0.05),训练6次后3组比较有统计学差异(F=62.80,P=0.000))。训练前3组缝合打结数分别为(1.9±0.3)、(2.2±1.2)、(2.5±1.4)个/10 min,无统计学差异(F=0.77,P=0.471),训练3次后低龄组10 min缝合打结数(8.9±1.2)个/10 min明显多于中龄组(5.1±1.6)个/10 min(q=8.924,P<0.05)和高龄组(4.3±1.2)个/10 min(q=10.802,P<0.05),训练6次后3组比较有统计学差异(F=35.76,P=0.000)。3组在训练前后1 min夹豆数、剪裁几何图形所需时间、10 min缝合打结数均有统计学差异(P<0.05)。结论腹腔镜模拟训练可以提高不同年龄参与者的腹腔镜操作技巧,年纪越轻培训的优势越明显。

Objective To explore the training effects of laparoscopic simulation training device on doctors of different ages. Methods Trainees were divided into three groups （ 10 persons in each group） ： younger group（ less than or equal to 25 years ）, middle group （more than 25 years but less than or equal to 35 years） and eider group （more than 35 years but less than or equal to 45 years）. Clipping beans, cutting graphs, sewing up and tying knots were trained. The scores of the three groups before and after the training were recorded and compared. Results Before training, the number of beans clipped were （9.2 ± 1.7 ） , （ 10.2 ± 1.2） and （9.0 ± 1.4）/min. There was no statistical difference in clipping beans（ F = 1.97, P = 0. 159 ） among the three groups. After 3 training periods, the number of beans clipped per minute in the younger group was （17.2 ± 2. l ）/min, much more than the middle group （ 14.2 ± 1.9 ）/rain （ q = 5. 342, P 〈 0.05 ） and the elder group （ 11.3 ± 1.2 ）/min （ q = 10. 507, P 〈 0.05 ）, furthermore, the number of beans clipped per minute in the middle group was much more than that in the elder group （ q = 5. 164,P 〈 0.05 ）. After 6 training periods, no statistical difference could be found between the 3 groups （F = 2.27,P = 0. 123）. Before training, the time needed for cutting graphs were （11. 2 ± 1. 6） , （ 10. 2 ± 1. 2） and （ 10. 2 ± 1. 2） min respectively, and no statistical difference was found （F = 1.84,P =0. 178）. After 3 training periods, the younger group needed （5.2 ± 1.1 ） min in cutting graphs,significantly shorter than the middle group （8.2±1.3）min （q=8.105,P〈0.05） and the elder group （11.2 ±1.1）min（q=16.210,P〈0.05）.The middle group needed less time than the elder group （ q = 8. 105, P 〈 0.05 ）. After 6 training periods, there was statistical difference between the 3 groups （ F= 62.80,P = 0. 000）. Before training, the number of knots tied in the 3 groups were （ 1.9 ± 0.3 ）, （2.2 ± 1.2） and（2.5 ± 1.4） /10 min respectively, with no statistical difference （ F = 0.77, P = 0.471 ）. After 3 training periods, the knots tied in the younger group were （8.9 ± 1.2）/10 min,more than that of the middle group （5.1 ± 1.6）/10 min（ q = 8. 924,P 〈 0.05 ） and the elder group （4.3 ± 1.2） /10 min （ q = 10. 802,P 〈 0.05 ）. After 6 training periods, statistical difference could be found in the 3 groups （ F = 35.76,P = 0. 000）. Compared with pretraining outcomes, there were statistical differences in the 3 groups in the number of beans clipped, time needed for cutting graphs, the number of knots after training （P 〈 0.05 ）. Conclusions Laparoscopic training could improve the laparoscopic skills of trainees of different ages. The younger trainees have better training effects.