缩短腹腔镜在甲状腺良性肿瘤手术中的初学者学习曲线研究

Research on shortening the learning curve of beginner for laparoscopy in benign thyroid tumor operation

目的:研究分析腹腔镜在甲状腺手术应用期间初学者的学习曲线,总结分析缩短初学者学习曲线的方法。方法:2011年8月-2013年2月收治腹腔镜手术治疗甲状腺良性肿瘤患者120例,根据手术的先后顺序分为Ⅰ组、Ⅱ组、Ⅲ组,每组40例,对比3组患者的手术时间、出血量、转为开放性手术率、并发症发生率及患者住院时间。结果:Ⅰ组患者术中出血量大,手术时间长,转为开放性手术率高,并发症发生率高,患者住院时间长,与Ⅱ组及Ⅲ组比较差异有统计学意义(P<0.05)。Ⅱ组与Ⅲ组患者各个指标比较不明显,差异无统计学意义(P>0.05)。结论:腹腔镜治疗甲状腺良性肿瘤初学者学习曲线约为40例,需要根据不同阶段给予不同指导,以达到更好的效果。

Objective:To research and analyze the learning curve of beginner for laparoscopy in benign thyroid tumor operation.To summarize and analyze the method of shortening the learning curve.Methods:120 cases with benign thyroid tumor treated with laparoscopic operation were selected from August 2011 to February 2013.They were divided into the Ⅰ group,Ⅱ group and Ⅲgroup with 40 cases in each group according to the sequence of operation.We compared the operation time,bleeding volume,opening operation rate,complication rate and hospitalization of the three groups.Results:In the Ⅰ group,bleeding volume was big,operation time was long,the rate of turning to open operation was high,the complication rate was high,and the hospitalization time was long.Compared with the Ⅱ group and Ⅲ group,the differences were statistically significant(P<0.05).The difference of each index between Ⅱ group and Ⅲ group was not obvious.There was no significant difference(P>0.05).Conclusion:The learning curve of beginner for laparoscopy in benign thyroid tumor operation is about 40 cases.We need to give different guiding according to different stages in order to achieve better results.