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目的:探讨腹腔镜根治性肾切除术(laparoscopic radical nephrectomy,LRN)手术模式的流程化设计对其学习曲线的影响。方法:将LRN手术模式进行流程化设计,并以此模式对青年腹腔镜医师进行LRN培训,然后于2009年1月～2011年1月间按此模式行LRN30例,分析其学习曲线,并与以往LRN学习曲线相比较。结果:试验组学习曲线的“转折点”较对照组明显提前。试验组的平均手术时间和平均术中出血量较对照组明显降低,差异有统计学意义,而中转开放例数和术后并发症较对照组亦有所减少,但差异无统计学意义。结论:通过对LRN进行流程化设计,进而制定LRN培训体系并对青年医师进行LRN培训,可以缩短LRN的学习曲线。
Objective: To investigate the effect of laparoscopic radical nephrectomy (LRN) procedure design on learning curve. Methods: The LRN surgical model was designed and used to train young laparoscopists in LRN. From January 2009 to January 2011, LRN was performed according to this model. The learning curve was analyzed and compared with Previous LRN learning curve compared. Results: The “turning point” of the learning curve of the experimental group was significantly earlier than that of the control group. The average operation time and average blood loss in the experimental group were significantly lower than those in the control group, with significant difference, while the number of cases of open transfer and postoperative complications also decreased compared with the control group, but the difference was not statistically significant. CONCLUSION: The learning curve of LRN can be shortened through the process design of LRN, then the development of LRN training system and LRN training for young doctors.