摘要
目的微创术式是目前治疗泌尿系结石的首选术式。文中探讨微创经皮肾镜(minimally invasive percutaneous nephrolithotomy,MPCNL)钬激光碎石术的学习曲线。方法回顾性分析2004年5月至2009年12月完成的用MPCNL治疗的患者210例。按手术时间先后分为7组,每组30例。结果 7组患者的通道建立时间有统计学差异(P=0.000),其中C、D、E、F、G各组间无显著性差异(P>0.05)。7组的手术时间有统计学差异(P<0.01),其中A、B 2组间(P<0.01)及B、C2组间(P=0.018)有显著差异,C、D、E、F、G各组间无明显差异。7组的输血率无统计学差异(P=0.496),结石清除率无统计学差异(P=0.243),全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)发生率无统计学差异(P=0.674)。结论经过60～90例MPCNL手术后,医师操作技术开始稳定。在医师培训中,通过60例手术病例的经验积累即可以单独进行MPCNL操作。
Objective Minimally invasive surgical treatment of urinary stones have become Preferred surgical procedure.This article is to study the learning curve of minimally invasive percutaneous nephrolithotomy（MPCNL）.MethodsBetween May 2004 and December 2009,210 cases of MPCNL in our hospital were analyzed retrospectively.According to the sequence of admission,patients were divided into 7 groups,30 cases in each group.ResultsThere were significantly differences in channel set-up time among the seven groups（P=0.000）,in which significant difference were found between group A and B（P=0.000）,and group B and C（P0.01）.No differences were found between group C,D,E,F,and G（P0.05）.There were significant differences in operating time among the seven groups（P0.01）,in which significant differences were found between group A and B（P0.01）,and between group B and C（P=0.018）.No differences were found between group C,D,E,F,and G（P0.05）.There were no differences in transfusion rate（P=0.496）,Stone clearance rate（P=0.243）,and incidence of systemic inflammatory response syndrome（SIRS）（P=0.674）.ConclusionMPCNL techniques began to stabilize after 60-90 cases.We believe that after 60 cases,Physicians can carry out MPCNL individually.
出处
《医学研究生学报》
CAS
2011年第3期268-271,共4页
Journal of Medical Postgraduates
基金
南京军区医药卫生科研基金(08MA090)
关键词
微创经皮肾镜碎石术
结石
学习曲线
Minimally invasive percutaneous nephrolithotomy
Calculus
Learning curve
