CAJ | 학술논문

目的调查经内镜胰胆管造影术(ERCP)手把手培训后受训医生返院后的ERCP开展情况,并分析相关影响因素.方法对2008年1月至2013年5月在西京消化病医院内镜中心进行ERCP培训的46名医生进行问卷调查,比较分析不同受训时间、受训期间操作例数、所处医疗机构条件等因素对学员后续ERCP工作开展情况的影响.结果共回收有效问卷41份(89.1％).其中34人来自三甲医院(82.9％).平均受训时间为8.9个月.41人中每月开展ERCP例数＜4的医生23人,例数≥4的医生18人.与开展ERCP例数少(＜4例/月)的医生相比,开展较多ERCP(≥4例/月)的医生所处医疗机构从事ERCP的医生人数更多[2(2～3)比1(1～2)人,P=0.005],拥有十二指肠镜≥2条的比例、学员自我估计的插管成功率≥90.0％的比例和使用针状刀预切开的比例更高(均P＜0.05).学员自我评估认为影响培训后ERCP开展的最主要3个因素是分别:医院的支持、个人操作能力和病例数量.结论学员受训后能否良好开展ERCP工作受诸多因素影响,包括受训后个人的操作能力、科室和医院的支持等.
목적 조사경내경이담관조영술(ERCP)수파수배훈후수훈의생반원후적ERCP개전정황,병분석상관영향인소.방법 대2008년1월지2013년5월재서경소화병의원내경중심진행ERCP배훈적46명의생진행문권조사,비교분석불동수훈시간、수훈기간조작례수、소처의료궤구조건등인소대학원후속ERCP공작개전정황적영향.결과 공회수유효문권41빈(89.1％).기중34인래자삼갑의원(82.9％).평균수훈시간위8.9개월.41인중매월개전ERCP례수＜4적의생23인,례수≥4적의생18인.여개전ERCP례수소(＜4례/월)적의생상비,개전교다ERCP(≥4례/월)적의생소처의료궤구종사ERCP적의생인수경다[2(2～3)비1(1～2)인,P=0.005],옹유십이지장경≥2조적비례、학원자아고계적삽관성공솔≥90.0％적비례화사용침상도예절개적비례경고(균P＜0.05).학원자아평고인위영향배훈후ERCP개전적최주요3개인소시분별:의원적지지、개인조작능력화병례수량.결론 학원수훈후능부량호개전ERCP공작수제다인소영향,포괄수훈후개인적조작능력、과실화의원적지지등.
Objective To evaluate the performance of trainees after finishing hands-on training of endoscopic retrograde cholangiopancreatography (ERCP) at our hospital.Methods Questionnaire was distributed to 46 trainees of ERCP training over the past 5 years.And the effects of training duration,case volume and hospital facilities on ERCP performance were examined.Results A total of 41 valid questionnaires (89.1％) were retrieved.And 34 trainees (82.9％) worked at tertiary medical centers.The mean training duration was 8.9 months.Compared with trainees with less annual ERCP volume (TL) (＜4cases per month,n =23),trainees with more volume (TM) (≥4 cases per month,n =18) had a higher rate of successful cannulation and precut by a needle knife (both P ＜ 0.05).More endoscopists could perform ERCP and more duodenoscopes were stocked at hospitals of TM compared with TL (both P ＜ 0.05).The results of trainee self-evaluation showed that the major influencing factors of post-training ERCP performance were hospital supports,handling capacity and case volume.Conclusion After hands-on training,the trainee performance of ERCP is influenced by such multiple factors as handling capacity and hospital supports,etc.