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目的探讨妇科腹腔镜全子宫切除术(TLH)学习曲线。方法将85例行TLH的患者按手术时间顺序分为4个阶段,其中第1、2、3阶段各20例,第4阶段25例。比较分析各个阶段的术中出血量、手术时间,并以简单正弦拟合学习曲线。结果第4阶段术中出血量低于第1阶段(P<0.05);第3、4阶段手术时间低于第1、2阶段,差异均有统计学意义(P<0.05),而第3阶段与第4阶段手术时间差异无统计学意义(P>0.05)。以简单的振荡正弦曲线Y=sinx-π/2拟合移动平均线,拐点为41例。结论 TLH的学习曲线大约为40例,即可达到较熟练水平和稳定程度。
Objective To investigate the learning curve of gynecological laparoscopic total hysterectomy (TLH). Methods Eighty-five patients with TLH were divided into four phases according to the operation time sequence, of which 20 cases were in stage 1, 2 and 3, and 25 cases in stage 4. Comparative analysis of the various stages of intraoperative bleeding, surgery time, and simple sinusoidal learning curve. Results The blood loss during the fourth stage was lower than that of the first stage (P <0.05). The operative time of the third and fourth stages was lower than that of the first and second stages, the difference was statistically significant (P <0.05) There was no significant difference between the operation time and stage 4 operation time (P> 0.05). The moving average line was fitted with a simple oscillating sinusoidal curve Y = sinx-π / 2 with 41 inflection points. Conclusion TLH learning curve is about 40 cases, you can reach a more proficient level and stability.