本文選題：氣管鏡 + 經(jīng)支氣管針吸活檢術(shù)��； 參考：《中國內(nèi)鏡雜志》2017年04期

【摘要】：目的針對已熟練掌握支氣管鏡操作技能的呼吸內(nèi)科醫(yī)師,通過評估經(jīng)支氣管針吸活檢術(shù)(TBNA)的穿刺時間和穿刺陽性率,探討TBNA的學習曲線規(guī)律。方法選取2013年5月-2014年8月在該院支氣管鏡室最初連續(xù)開展的60例行TBNA檢查患者的病例資料。按TBNA操作先后順序依次分為4組(A、B、C和D),每組15例設(shè)為一操作學習階段,每例均由同一位醫(yī)師操作完成TBNA檢查。比較各階段的平均穿刺時間、穿刺陽性率及穿刺并發(fā)癥。結(jié)果各組病例在性別、年齡等方面差異無統(tǒng)計學意義(P0.05)。A組(15.2±2.0)min和B組(14.7±2.2)min穿刺時間均長于C組(8.3±1.6)min和D組(7.6±1.3)min,且差異有統(tǒng)計學意義(P0.05),但A組和B組之間及C組和D組之間穿刺時間差異無統(tǒng)計學意義(P0.05);A組(26.7%)和B組(33.3%)穿刺陽性率均低于C組(80.0%)和D組(80.0%),且差異有統(tǒng)計學意義(P0.05),但A組和B組之間及C組和D組之間穿刺陽性率差異無統(tǒng)計學意義(P0.05);各組穿刺誤入血管,穿刺后引起的穿刺點黏膜出血、氣胸、縱隔血腫、縱隔出血及縱隔感染等并發(fā)癥均無明顯差異。結(jié)論對已熟練掌握支氣管鏡操作技能的呼吸內(nèi)科醫(yī)師,經(jīng)支氣管針吸活檢術(shù)的學習曲線大約為30例。
[Abstract]:Objective to investigate the learning curve of TBNA by evaluating the puncture time and the positive rate of puncture for the respiratory physician who has mastered the skill of bronchoscopy.Methods from May 2013 to August 2014, 60 consecutive TBNA examinations were performed in the bronchoscope room of the hospital.According to the sequence of TBNA operation, the patients were divided into 4 groups in order, 15 cases in each group were set up as an operation learning stage, each case was performed TBNA examination by the same doctor.The average puncture time, puncture positive rate and puncture complications were compared.Results the cases in each group were sex,There was no significant difference in age between group A (15.2 鹵2.0)min) and group B (14.7 鹵2.2)min). The puncture time of group A was significantly longer than that of group C (8.3 鹵1.6)min) and group D (7.6 鹵1.3 min), but there was no significant difference in puncture time between group A and group B and between group C and group D.The positive rate of puncture in group A and group B was lower than that in group C (80.010) and group D (80.0), and the difference was statistically significant (P 0.05), but there was no significant difference between group A and group B and between group C and group D (P0.05), and there was no significant difference in puncture positive rate between group A and group B and between group C and group D, and there was no significant difference in puncture positive rate between group A and group B and between group C and group D, and there was no significant difference in puncture positive rate between group A and group B and between group C and group D;There was no significant difference in mucosal bleeding, pneumothorax, mediastinal hematoma, mediastinal hemorrhage and mediastinal infection.Conclusion for the respiratory physician who has mastered the skill of bronchoscopy, the learning curve of bronchus needle aspiration biopsy is about 30 cases.
【作者單位】： 安徽省蕪湖市第二人民醫(yī)院呼吸內(nèi)科;
【分類號】：R768.1
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本文編號：1762167