| 基金项目:重庆市研究生教育教学改革研究项目（yjg173078）；重庆市中青年医学高端人才培养项目 |
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| 中文摘要: |
| 目的 介绍美国匹兹堡大学开展的机器人手术培训课程经验。方法 详细介绍培训课程的具体流程，同时对培训结果进行总结分析。共有15位学员完成了第一阶段培训（操作台模拟训练），14位（93.3％）完成了第二阶段（胰十二指肠切除组织吻合模拟训练），累计完成196例组织吻合模拟训练。采用STATA和SPSS软件进行统计分析，对得分进行Wilcoxon秩和检验。结果 吻合模拟训练的表面效度Likert量表平均分分别为：胰空肠吻合（Pancreaticojejunostomy，PJ）（15/20），胃空肠吻合（Gastrojejunostomy，GJ）（15/20）和胆空肠吻合（Hepatocholangiojejunostomy，HJ）（17/20）。在PJ和GJ模拟训练中，与金标准相比，失误率和OSATS得分均改善（P>0.05），操作用时无减少（P<0.05）；在HJ模拟培训中，失误率、OSATS得分和操作用时均未见改善（P<0.05）。但将学员重复进行的吻合训练结果作为一个整体进行线性回归和二次拟合模型分析显示，学员培训后的所有模拟操作均较首次表现得更好。结论 美国匹兹堡大学医学中心开展的培训课程是行之有效的，对探索出一条符合我国国情的机器人外科发展之路具有借鉴意义。 |
| 英文摘要: |
| Objective To introduce the experience of robotic surgery training course in the University of Pittsburgh Medical Center.Methods The specific process of the training course was introduced in detail, and the results of the training course were summarized and analyzed. A total of 15 surgeons completed the first step of the training (operation table simulation training), 14 (93.3%) completed the second step (pancreatoduodenectomy tissue anastomosis simulation training), and 196 cases of tissue anastomosis simulation training were completed. Statistical analysis was performed using STATA and SPSS software. Wilcoxon rank sum test was used to analyze the data.Results The average scores of the surface validity Likert scale for anastomosis simulation training were: (15/20) for Pancreaticojejunostomy (PJ), (15/20) for Gastrojejunostomy (GJ), and (17/20) for Hepatocholangiojejunostomy (HJ). In the PJ and GJ simulation training, compared with the gold standard, the error rate and OSATS score were significantly improved (P > 0.05), and the operation time was not significantly reduced (P < 0.05). In HJ simulation training, the error rate, OSATS score and operation time did not show significant improvement (P < 0.05). However, it could be concluded that all the simulation operations performed by the trainees after the training were better than the first time, when linear regression and quadratic fitting models were performed to analyze continuous trainings of the trainees as a group.Conclusion The training course carried out by the University of Pittsburgh Medical Center is valid and effective, and it can be used for reference to explore a way for the development of robotic surgery fitting to the real conditions of our country. |
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