在高级内镜培训期间ERCP的临床结果和学习曲线:卧式与俯卧式定位的比较
Danny Issa1, Reem Z Sharaiha2, Thaer Abdelfattah3
1Division of Digestive Diseases.
Gastrointestinal endoscopy
|June 29, 2023
概括
在内镜逆行胆大脑造影 (ERCP) 过程中患者的定位不会影响学员的管成功率. 然而,仰卧姿势可以缩短手术时间,帮助高级内镜学员的学习曲线.
科学领域:
- 胃肠病学 胃肠病学
- 医学教育 医学教育
- 内镜手术 进行内镜手术
背景情况:
- 有限的研究存在于患者定位对内逆流胆大脑图 (ERCP) 学习成果的影响.
- 在ERCP培训中,不存在对仰卧和俯卧位置的同时评估.
研究的目的:
- 为了确定患者的位置 (仰卧或俯卧) 是否会影响ERCP的程序结果和学习曲线.
- 为了比较卧姿和卧姿ERCP之间的管成功率,手术时间和学习进展.
主要方法:
- 由监督高级内镜实习生 (AET) 进行ERCP的原生乳头成年患者的前性评估.
- 标准化协议,每次多达5次试射一次.
- 每季度评估结果以评估学习曲线.
主要成果:
- 在仰卧 (69%) 和倾斜 (68%) 位置 (P=.95) 观察到类似的成功管率.
- 虽然在卧卧姿势下,乳头的时间较短,但胆管通道的时间和试图数量是可比的.
- 在整个学年中,炮射率显著增加,卧卧姿势的增加更大 (P=.01).
- 卧式ERCP的程序和总室时间显著缩短.
结论:
- 仰卧式ERCP与较短的程序和房间周转时间有关,与倾斜的位置相比.
- 患者的位置不会显著影响受训人员的ERCP管成功率.
- 仰卧姿势可能为ERCP培训效率提供优势,因为程序时间缩短.
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