实时超声引导下经皮肾脏穿刺学习曲线及并发症评估价值研究

Evaluation of Learning Curve and Complications of Percutaneous Renal Puncture Under Real-time Ultrasound Guidance

目的通过研究实时超声引导下经皮肾脏穿刺术围手术期并发症和学习曲线的关系,旨在了解实时超声引导下经皮肾脏穿刺术在学习曲线期的安全性,为实时超声引导下经皮肾脏穿刺术的推广提供参考。方法回顾2018年10月-2019年10月由一名超声医生开展的150例实时超声引导下经皮肾脏穿刺术,根据手术时间先后,分为A、B、C、D、E 5组,进行学习曲线分析。依据手术时间,穿刺次数和并发症例数和病例数汇出学习曲线,分别统计各组并发症发生情况。结果手术时间A组与B、C、D、E组各组差异有统计学意义(P<0.05),提示30例为学习曲线期。B、C、D、E组各组间手术时间差异无统计学意义(P>0.05),全组患者手术顺利,无围手术期死亡。所有并发症发生率各组间比较差异无统计学意义(P>0.05)。结论实时超声引导下经皮肾脏穿刺术学习曲线为30例左右,实时超声引导下经皮肾脏穿刺术并发症在学习曲线的早期和成熟期没有区别,具有同样的安全性。

Objective To compare the rate of complications between the learning stage and the experienced stage of learning curve,and to provide some information and guidance for the promotion of real-time ultrasonographyguided percutaneous renal biopsy.Methods 150 cases of real-time ultrasound-guided percutaneous renal puncture performed by an ultrasound doctor from October 2018 to October 2019 were reviewed.According to the operation time,they were divided into groups A,B,C,D and E for learning curve analysis.According to the operation time,puncture times,the number of complications and the number of cases,the learning curve was collected,and the incidence of complications in each group was counted respectively.Results There was significant difference in operation time between group A and groups B,C,D and E(P<0.05).B.There was no significant difference in operation time among groups C,D and E(P>0.05).The operation of the whole group was smooth and there was no perioperative death.There was no significant difference in the incidence of all complications among the groups(P>0.05).Conclusion The learning curve of real-time ultrasound-guided percutaneous renal puncture was about 30 cases.The complications of real-time ultrasound-guided percutaneous renal puncture had no difference in the early and mature stages of the learning curve,and had the same safety.