【摘要】 目的探讨B超引导下经皮肾镜取石术中建立皮肾通道的学习曲线。方法回顾分析2006年1月～2007年7月由一名泌尿外科医生完成的B超引导下经皮肾镜取石术60例的临床资料,按手术时间先后顺序分为6组,每组10例,比较各组皮肾通道建立时间及清石率等指标的差异。结果第1组建立皮肾通道时间为(15.0±2.7)min,第2组为(14.0±2.1)min,第3组为(10.2±1.2)min,第4组为(5.8±0.7)min,第5组为(7.5±1.2)min,第6组为(6.6±0.9)min。方差分析组间皮肾通道建立时间有显著差异(F=5.77,P=0.000),2组间比较第1组与第4组(q=5.655,P<0.05)、第1组与第5组(q=4.610,P<0.05)、第1组与第6组(q=5.163,P<0.05)、第2组与第4组(q=5.040,P<0.05)、第2组与第5组(q=3.995,P<0.05)、第2组与第6组(q=4.549,P<0.05)皮肾通道建立时间有显著统计学差异,其余2组间比较均无显著统计学差异(P>0.05)。6组的清石率分别为70%、60%、70%、80%、90%及70%,各组比较无显著统计学差异(χ2=2.727,P=0.742)。结论学习经皮肾镜手术是个渐进的过程,完成30例手术后开始熟悉B超引导下建立皮肾通道,缩短建立皮肾通道的时间。更多还原

【Abstract】 Objective To evaluate the learning curve in percutaneous nephrolithotomy under the guidance of B ultrasonography.Methods From January 2006 to July 2007,totally 60 cases of percutaneous nephrolithotomy were performed under the guidance of B ultrasonography by a single urologist.The patients were divided into 6 groups according to the date of the operation(10 cases in each).The time for setting the renal access and the stone-free rate were compared among the groups.Results The time for setting the renal access was(15.0±2.7),(14.0±2.1),(10.2±1.2),(5.8±0.7),(7.5±1.2),and(6.6±0.9)minutes respectively in group 1 to 6.ANOVA analysis showed significant difference among the groups(F=5.734,P=0.000).Significant difference was detected between groups 1 and 4(q = 5.655,P<0.05),groups 1 and 5(q=4.610,P<0.05),groups 1 and 6(q=5.163,P<0.05),groups 2 and 4(q= 5.040,P<0.05),groups 2 and 5(q=3.995,P<0.05),and groups 2 and 6(q=4.549,P<0.05).The stone-free rate was 70%,60%,70%,80%,90%,and 70% retrospectively in the groups 1 to 6(χ2=2.272,P=0.742).Conclusions The skill of the surgeon improved gradually when learning PCNL.After finished 30 procedures,the time for setting the renal access can be reduced significantly.更多还原