摘要: |
目的 探讨腹腔镜超声引导下微波消融治疗肝细胞性肝癌的学习曲线。方法 回顾性分析我院同一名超声医师行腹腔镜超声引导下微波消融治疗的肝细胞性肝癌患者50例,按治疗时间先后顺序分为5组(A~D组),每组10例;比较各组腹腔镜超声扫查到病灶时间、腹腔镜超声引导进针时间、出血量及手术并发症,分析各组手术疗效。结果 5组患者在年龄、性别、肿块直径和并发症比较,差异均无统计学意义。腹腔镜超声扫查到病灶时间由A组的(17.6±2.6)min下降至E组的(5.5±0.8)min,腹腔镜超声引导进针时间由A组的(268.0±42.6)s下降至E组的(48.0±21.5)s,出血量由A组的(71.5±15.3)ml下降至E组的(19.0±6.6)ml,差异均有统计学意义(均P=0.000)。腹腔镜超声扫查到病灶时间曲线图及腹腔镜超声引导一次进针时间曲线图中, C组和D组是统计学意义上的学习拐点。结论 腹腔镜超声引导下微波消融治疗肝细胞性肝癌的学习曲线大约为30例,即可达到熟练程度。 |
关键词: 腹腔镜超声 微波消融 肝细胞性肝癌 学习曲线 |
DOI: |
投稿时间:2018-01-15修订日期:2018-09-21 |
基金项目: |
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Learning curve of microwave ablation therapy guided by laparoscopic ultrasound in hepatocellular carcinoma |
wang dan,luo hong chang |
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Abstract: |
Objective To investigate the learning curve of laparoscopic ultrasound-guided microwave ablation in the treatment of hepatocellular carcinoma.Methods 50 patients undergoing laparoscopic ultrasound-guided microwave treatment of hepatocellular carcinoma performed by the same ultrasound physician were retrospectively analyzed.The patients were divided into 5 groups (from A to E) according to therapy time.Laparoscopic ultrasound scan to the lesion time,Laparoscopic ultrasound guided into the needle time,bleeding volume and complications were compared between the 5 groups. Results There were no significant differences between the 5 groups with respect of age,gender,tumor diameter and complications.The laparoscopic ultrasound scan to the lesion time in group A was(17.6±2.6)min and decreased to(5.5±0.8)min in group E(P=0.000).The laparoscopic ultrasound guided into the needle time in group A was(268.0±42.6)s and decreased to(48.0±21.5)s in group E(P=0.000).The bleeding volume in group A was(71.5±15.3)ml and decreased to(19.0±6.6)ml in group E(P=0.000). Laparoscopic ultrasound scan to the lesion time curve and Laparoscopic ultrasound guided into the needle time curve ,Groups C and D are statistically significant learning inflection points. Conclusion From the learning curve of microwave ablation therapy guided by laparoscopic ultrasound in hepatocellular carcinoma,ultrasound physicians can learn such skill after performing 30 cases. |
Key words: Laparoscopic ultrasound Microwave ablation Hepatocellular carcinoma Learning curve |