随机对照临床试验在外科中的局限性

Limitations of randomized controlled trial in surgery

随机对照临床试验(RCT)作为循证医学最高级别证据,一直被认为是临床证据中的“金标准”。但随着近现代医学的发展,尤其是外科学、外科新技术的不断涌现,RCT的局限性也逐渐暴露出来。本文通过回顾RCT的历史,观察RCT在医学各领域的作用,分析RCT在外科新技术中的局限性,并探讨培训体系的建立在外科新技术的成熟、发展过程中所起到的重要作用,为同道们正确看待RCT抛砖引玉。

Randomized controlled trial(RCT),as the highest level evidence of evidence-based medicine,has always been regarded as the"gold standard"in clinical evidence.However,with the development of modern medicine,especially the emergence of new surgical techniques,the limitations of RCT are gradually exposed.This paper reviews the history of RCT,observes the role of RCT in various fields of medicine,analyzes the limitations of RCT in new surgical technology,and discusses the important role of the establishment of training system in the maturity and development of new surgical technology,so as to throw bricks and jade for colleagues to treat RCT correctly.