| 吴少杰,方主亭,蔡森林,唐仪,周艳峰,陈平舟.分析前列腺动脉栓塞治疗前列腺增生操作者学习曲线[J].中国介入影像与治疗学,2019,16(7):410-414 |
| 分析前列腺动脉栓塞治疗前列腺增生操作者学习曲线 |
| Analysis of operator learning curve of prostatic artery embolization for prostatic hyperplasia |
| 投稿时间：2019-01-11 修订日期：2019-06-21 |
| DOI：10.13929/j.1672-8475.201901022 |
| 中文关键词: 前列腺增生 栓塞,治疗性 学习曲线 |
| 英文关键词:prostatic hyperplasia embolization, therapeutic learning curve |
| 基金项目:福建省卫生计生中青年骨干人才培养项目（2017-ZQN-1）。 |
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| 中文摘要: |
| 目的 分析前列腺动脉栓塞（PAE）治疗前列腺增生（PH）的操作者学习曲线。方法 回顾分析由同一具有5年以上外周血管介入治疗经验医师行PAE治疗的第1~60例PH患者的资料，按治疗顺序分为A、B、C组，每组20例。比较各组间PAE手术时间、术中X线曝光时间、患者术后住院时间的差异；对比分析术前与术后3个月国际前列腺症状评分（IPSS）、生活质量评分（QOL）、前列腺体积、最大尿流率（Qmax）及残余尿量（PVR）。结果 3组PAE术前前列腺体积、IPSS评分、QOL评分、Qmax及PVR差异均无统计学意义（P均>0.05）；手术时间及术中X线曝光时间差异均有统计学意义（F=32.74、13.57，P均<0.01），其中A组手术时间及术中X线曝光时间明显长于B组（P均<0.01）及C组（P均<0.01），B组与C组间差异均无统计学意义（P=0.22、0.30）。3组患者术后住院时间差异无统计学意义（F=0.17，P=0.84）。PAE术后3个月，A、B、C组IPSS评分（t=14.66、11.74、29.02）、QOL评分（t=8.51、8.19、7.99）及PVR（t=11.68、12.71、16.80）均低于术前（P均<0.01），Qmax均（t=-11.72、-10.80、-7.74）较术前明显升高（P均<0.01），前列腺体积（t=14.75、17.45、27.42）均较术前明显减小（P均<0.01）。结论 PAE治疗PH近期疗效确切。医师积累20例PAE手术经验后，后续手术时间及曝光时间明显缩短，学习曲线进入平台期。 |
| 英文摘要: |
| Objective To analyze the operator learning curve of prostatic artery embolization (PAE) in treatment of prostatic hyperplasia (PH). Methods Data of the first to 60th PH patients treated with PAE by the same operator having more than 5 years' experiences of peripheral vascular interventional therapy were retrospectively analyzed. The patients were divided into groups A, B and C according to the treatment order (each n=20). PAE operation time, intraoperative X-ray exposure time and post-operation hospitalization were compared among groups. International prostate symptom score (IPSS) and quality of life score (QOL), prostate volume, maximum flow rate (Qmax) and post void residual (PVR) before and after operation were analyzed. Results There was no statistical difference of prostate volume, IPSS score, QOL score, Qmax nor PVR among three groups before PAE (all P>0.05).There were significantly statistical differences of operation time and intraoperative X-ray exposure time (F=32.74, 13.57, both P<0.01) among 3 groups. Pairwise comparison showed the operation time and intraoperative X-ray exposure time in group A were significantly longer than those in group B (both P<0.01) and group C (both P<0.01), while the differences between group B and C were not statistical (P=0.22, 0.30). No statistical difference of post-operation hospitalization was found among 3 groups (F=0.17, P=0.84). Three months after PAE, IPSS score (t=14.66, 11.74, 29.02), QOL score (t=8.51, 8.19, 7.99), PVR (t=11.68, 12.71, 16.80) and prostate volume (t=14.75, 17.45, 27.42) decreased compared with those before operation in all 3 groups (all P<0.01), and Qmax (t=-11.72, -10.80, -7.74) also statistically increased (all P<0.01). Conclusion PAE is effective for PH in short-term. After accumulating 20 cases of PAE operation experience, the operation time and X-ray exposure are significantly shortened, and the learning curve turn to the plateau stage. |
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