加速康复外科理念在肝脏外科专科医生培养中的应用

Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists

目的探讨加速康复外科理念在肝脏外科专科医生培养中的应用效果。方法选取2017至2019年在浙江大学医学院附属第一医院肝胆胰外科接受6个月专科培训的主治医生60名,随机分成对照组和研究组。对照组采用传统外科理念的专科医生培养模式,研究组采用融合加速康复外科理念的专科医生培养模式。分别在培训结束时对两组学员进行理论考核和临床实践考核。采用SPSS 25.0统计软件进行t检验和卡方检验。结果研究组在专科理论考核[(91.70±2.87)vs.(89.60±2.88),P=0.006]、临床思维考核[(93.17±2.78)vs.(86.33±3.70),P<0.001]和手术模拟操作考核[(92.83±2.84)vs.(89.50±3.31),P=0.013]方面成绩均明显高于对照组。问卷调查结果显示,研究组专科学员满意度也优于对照组[(91.50±3.26)vs.(84.67±3.46),P<0.001]。临床实践考核结果显示,相比较于对照组,研究组专科医生管理的患者术后康复更快[住院天数:(6.10±1.80)vs.(9.90±1.60),P<0.001]。结论融合加速康复外科理念的肝脏外科专科医生培养模式,能使专科医生更好地掌握肝脏外科理论知识和实践操作技能,最终使患者获益。

Objective To investigate the application effect of the concept of enhanced recovery after surgery(ERAS)in the training of hepatic surgery specialists.Methods Sixty attending physicians who had received 6 months of specialist training in the Hepatopancreatobiliary Surgery of the First Affiliated Hospital,School of Medicine,Zhejiang University,China in 2017-2019 were randomly divided into the control group and research group.The control group adopted the traditional training mode of hepatic surgery specialists,and the research group adopted the training mode of hepatic surgery specialists integrating the concept of ERAS.At the end of the training,the two groups were evaluated through theoretical examination and clinical practice.SPSS 25.0 was used for t test and Chi-square test.Results The scores in theoretical knowledge[(91.70±2.87)vs.(89.60±2.88),P=0.006],clinical thinking[(93.17±2.78)vs.(86.33±3.70),P<0.001],and surgical simulation[(92.83±2.84)vs.(89.50±3.31),P=0.013]were significantly better in the research group than in the control group.The questionnaire results showed that the satisfaction of specialists in the research group was better than that in the control group[(91.50±3.26)vs.(84.67±3.46),P<0.001].The results of clinical practice assessment showed that the patients managed by the specialist in the research group had faster postoperative recovery compared with the control group(length of stay:6.10±1.80 vs.9.90±1.60,P<0.001).Conclusion The training mode of hepatic surgery specialists integrating the concept of ERAS enables specialists to better master the theoretical knowledge and practical operation skills of hepatic surgery,and ultimately benefits patients.