CAJ | 학술논문

目的：探讨团队配合的训练课程在腹腔镜技能培训中的价值。方法2012年12月～2014年3月我院普外科卫生部内镜诊疗培训基地共举办培训班4期，培训内容包括腹腔镜基础理论学习、模拟操作训练、动物实体的各种腹腔镜手术操作训练等，在后2期的培训内容中，我们设计并增加与团队配合有关的腹腔镜培训课程，在动物实体的腹腔镜手术训练中，记录4期培训班各组学员的腹腔镜胆囊切除术及脾切除术的手术时间和术中出血量。我们将后两期学习班的学员设为实验组，前两期学员设为对照组，对2组结果进行比较。结果实验组腹腔镜胆囊切除手术时间（63．8±16．8）min，显著短于对照组（82．8±12．5）min（t＝2．566，P＝0．022）；腹腔镜脾切除手术时间（88．7±17．1） min，显著短于对照组（119．0±18.1） min（t＝3．442，P＝0．004）；腹腔镜胆囊切除术中出血量（46．2±12．8）ml，显著少于对照组（96．6±22．5）ml（t＝5．507，P＝0.000）；腹腔镜脾切除术中出血量（91．8±15．3）ml，显著少于对照组（146．9±18．5）ml（t＝6．492，P＝0．000）。结论增加团队配合训练内容的腹腔镜培训课程更加符合腹腔镜手术的特点，可提高腹腔镜培训的效果，值得推广。
목적：탐토단대배합적훈련과정재복강경기능배훈중적개치。방법2012년12월～2014년3월아원보외과위생부내경진료배훈기지공거판배훈반4기，배훈내용포괄복강경기출이론학습、모의조작훈련、동물실체적각충복강경수술조작훈련등，재후2기적배훈내용중，아문설계병증가여단대배합유관적복강경배훈과정，재동물실체적복강경수술훈련중，기록4기배훈반각조학원적복강경담낭절제술급비절제술적수술시간화술중출혈량。아문장후량기학습반적학원설위실험조，전량기학원설위대조조，대2조결과진행비교。결과실험조복강경담낭절제수술시간（63．8±16．8）min，현저단우대조조（82．8±12．5）min（t＝2．566，P＝0．022）；복강경비절제수술시간（88．7±17．1） min，현저단우대조조（119．0±18.1） min（t＝3．442，P＝0．004）；복강경담낭절제술중출혈량（46．2±12．8）ml，현저소우대조조（96．6±22．5）ml（t＝5．507，P＝0.000）；복강경비절제술중출혈량（91．8±15．3）ml，현저소우대조조（146．9±18．5）ml（t＝6．492，P＝0．000）。결론증가단대배합훈련내용적복강경배훈과정경가부합복강경수술적특점，가제고복강경배훈적효과，치득추엄。
Objective To evaluate the teamwork simulation module ( TSM ) in training of laparoscopic skills . Methods From December 2012 to March 2014, four laparoscopic skills training sessions were held in our endoscopy training base .The training content included basic theory , simulation of single laparoscopic techniques , and a series of laparoscopic surgeries performed on swine . We designed and added the TSM training in the last two sessions .The operation time and blood loss of laparoscopic porcine cholecystectomy ( LPC) and laparoscopic porcine splenectomy ( LPS ) were recorded and analyzed between the first two sessions ( Control Group ) and the last two sessions ( Experimental Group ) . Results The operation time of LPC was significantly shorter in the Experimental Group (63.8 ±16.8 min) than that in the Control Group (82.8 ±12.5 min) (t=2.566, P=0.022), the same as the operation time of LPS in the Experimental Group (88.7 ±17.1 min) and in the Control Group (119.0 ±18.1 min) ( t=3.442, P=0.004).The intraoperative blood loss of LPC was significantly less in the Experimental Group (46.2 ±12.8 ml) than that in the Control Group (96.6 ±22.5 ml) (t=5.507, P=0.000), the same as the intraoperative blood loss of LPS in the Experimental Group (91.8 ±15.3 ml) and in the Control Group (146.9 ±18.5) (t =6.492, P =0.000). Conclusion The TSM training of laparoscopic skills is consistent with the characteristics of laparoscopic techniques , helping improving the effectiveness of laparoscopic skills learning and being worthy of popularization .