在泌尿器科住院培训计划中分析卧式皮肤透神经瘤的学习曲线:比较分析
Yusuf Arıkan1, Yavuz Onur Danacioğlu2, Deniz Noyan Özlü3
1Departmant of Urology, İzmir Tepecik Training and Research Hospital, İzmir, Türkiye. dryusufarikan@gmail.com.
Urolithiasis
|September 9, 2024
概括
随着经验的增长,上皮穿透性脑膜切除术 (PCNL) 的结果会有所改善. 住院人员获得了熟练的技能,减少了手术时间和并发症,同时增加了无石头率 (SFR).
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术技巧 手术技巧
- 医学教育 医学教育
背景情况:
- 透皮石切除术 (PCNL) 是结石去除的关键手术.
- 卧式PCNL技术为这种干预提供了一个替代的定位.
- 了解学习曲线对于优化外科培训和患者结果至关重要.
研究的目的:
- 评估在卧床上进行皮肤穿神经切除术 (PCNL) 的住院人员的学习曲线和熟练程度.
- 为了比较初级住院医生,高级住院医生和经验丰富的内分泌科医生之间的结果.
- 为了确定达到稳定无石头率 (SFR) 并尽量减少并发症所需的病例数量.
主要方法:
- 在2018年1月至2024年1月期间进行的卧床PCNL病例的回顾性审查.
- 患者被分为三组:2-3年住院医生 (第一组),4-5年住院医生 (第二组) 和内分泌科医生 (第三组).
- 分析的结果包括接入时间,光镜时间,手术时间,术后停留时间,需要额外治疗,无石头率 (SFR) 和并发症率.
主要成果:
- 程序时间 (访问,光学,手术) 从1组大幅减少到3组.
- 术后停留时间和需要额外治疗的时间随着经验的增加而减少.
- 在各组中,无石头率 (SFR) 显著增加,在初级居民的46-60例和高级居民的31-45例后实现了稳定的SFR. 1组的并发症率最高,3组的并发症率最低.
结论:
- 苏平PCNL表现出明显的学习曲线,随着经验的增加,效率和安全性得到了显著改善.
- 年轻居民需要大约46-60个病例才能达到稳定的无石头率,而老年居民在31-45个病例后才能实现这一目标.
- 随着逐渐的经验,卧式PCNL技术变得更加有效和安全,突出显示了监督培训和病例数量的重要性.
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