加速康复外科理念在肝脏外科专科医生培养中的应用

厉智威; 施毓

doi:10.3760/cma.j.cn116021-20210711-01359

您当前的位置：

首页 >

文章列表页 >

加速康复外科理念在肝脏外科专科医生培养中的应用

专科医师培养 | 更新时间：2023-08-02

- 加速康复外科理念在肝脏外科专科医生培养中的应用
- Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists
- 中华医学教育探索杂志 2023年22卷第7期页码：1079-1082
- 作者机构：
  
  1.浙江大学医学院附属第一医院肝胆胰外科，杭州　310003
  2.浙江大学医学院附属第一医院感染科，杭州　310003
- 作者简介：
  
  厉智威，Email：zylzw@zju.edu.cn
- 基金信息：
  
  浙江省教育厅课题(Y201534669);浙江省基础公益研究计划项目(LQ18H070003)
- DOI：10.3760/cma.j.cn116021-20210711-01359
  中图分类号： R656
- 纸质出版日期：2023-07-20，
  
  收稿日期：2021-07-11，
扫描看全文
厉智威, 施毓. 加速康复外科理念在肝脏外科专科医生培养中的应用[J]. 中华医学教育探索杂志, 2023, 22(7): 1079-1082.

Li Zhiwei, Shi Yu. Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists[J]. Chinese Journal of Medical Education Research, 2023,22(7):1079-1082.
厉智威, 施毓. 加速康复外科理念在肝脏外科专科医生培养中的应用[J]. 中华医学教育探索杂志, 2023, 22(7): 1079-1082. DOI： 10.3760/cma.j.cn116021-20210711-01359.

Li Zhiwei, Shi Yu. Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists[J]. Chinese Journal of Medical Education Research, 2023,22(7):1079-1082. DOI： 10.3760/cma.j.cn116021-20210711-01359.

摘要

目的

探讨加速康复外科理念在肝脏外科专科医生培养中的应用效果。

方法

选取2017至2019年在浙江大学医学院附属第一医院肝胆胰外科接受6个月专科培训的主治医生60名，随机分成对照组和研究组。对照组采用传统外科理念的专科医生培养模式，研究组采用融合加速康复外科理念的专科医生培养模式。分别在培训结束时对两组学员进行理论考核和临床实践考核。采用SPSS 25.0统计软件进行

检验和卡方检验。

结果

研究组在专科理论考核[（91.70±2.87） vs. （89.60±2.88），

=0.006]、临床思维考核[（93.17±2.78） vs. （86.33±3.70），

0.001]和手术模拟操作考核[（92.83±2.84） vs. （89.50±3.31），

=0.013]方面成绩均明显高于对照组。问卷调查结果显示，研究组专科学员满意度也优于对照组[（91.50±3.26） vs. （84.67±3.46），

0.001]。临床实践考核结果显示，相比较于对照组，研究组专科医生管理的患者术后康复更快[住院天数：（6.10±1.80） vs. （9.90±1.60），

0.001]。

结论

融合加速康复外科理念的肝脏外科专科医生培养模式，能使专科医生更好地掌握肝脏外科理论知识和实践操作技能，最终使患者获益。

Abstract

Objective

To investigate the application effect of the concept of enhanced recovery after surgery (ERAS) in the training of hepatic surgery specialists.

Methods

Sixty attending physicians who had received 6 months of specialist training in the Hepatopancreatobiliary Surgery of the First Affiliated Hospital

School of Medicine

Zhejiang University

China in 2017-2019 were randomly divided into the control group and research group. The control group adopted the traditional training mode of hepatic surgery specialists

and the research group adopted the training mode of hepatic surgery specialists integrating the concept of ERAS. At the end of the training

the two groups were evaluated through theoretical examination and clinical practice. SPSS 25.0 was used for

test and Chi-square test.

Results

The scores in theoretical knowledge [(91.70±2.87) vs. (89.60±2.88)

= 0.006]

clinical thinking [(93.17±2.78) vs. (86.33±3.70)

0.001]

and surgical simulation [(92.83±2.84) vs. (89.50±3.31)

= 0.013] were significantly better in the research group than in the control group. The questionnaire results showed that the satisfaction of specialists in the research group was better than that in the control group [(91.50±3.26) vs. (84.67±3.46)

0.001]. The results of clinical practice assessment showed that the patients managed by the specialist in

the research group had faster postoperative recovery compared with the control group (length of stay: 6.10±1.80 vs. 9.90±1.60

0.001).

Conclusion

The training mode of hepatic surgery specialists integrating the concept of ERAS enables specialists to better master the theoretical knowledge and practical operation skills of hepatic surgery

and ultimately benefits patients.

关键词

专科医生加速康复外科肝脏外科

Keywords

SpecialistEnhanced recovery after surgeryHepatic surgery

references

Wang FS, Fan JG, Zhang Z, et al. The global burden of liver disease: the major impact of China [J]. Hepatology, 2014, 60(6): 2099-2108. DOI: 10.1002/hep.27406http://dx.doi.org/10.1002/hep.27406.

Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation [J]. Br J Anaesth, 1997, 78(5): 606-617. DOI: 10.1093/bja/78.5.606http://dx.doi.org/10.1093/bja/78.5.606.

Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery [J]. Ann Surg, 2008, 248(2): 189-198. DOI: 10.1097/SLA.0b013e31817f2c1ahttp://dx.doi.org/10.1097/SLA.0b013e31817f2c1a.

中国研究型医院学会肝胆胰外科专业委员会. 肝胆胰外科术后加速康复专家共识（2015版）[J]. 中华消化外科杂志, 2016, 15(1): 1-6. DOI: 10.3760/cma.j.issn.1673-9752.2016.01.001http://dx.doi.org/10.3760/cma.j.issn.1673-9752.2016.01.001.

Ishizawa T, Gumbs AA, Kokudo N, et al. Laparoscopic segmentectomy of the liver: from segment I to VⅢ [J]. Ann Surg, 2012, 256(6): 959-964. DOI: 10.1097/SLA.0b013e31825ffed3http://dx.doi.org/10.1097/SLA.0b013e31825ffed3.

Agarwal V, Divatia JV. Enhanced recovery after surgery in liver resection: current concepts and controversies [J]. Korean J Anesthesiol, 2019, 72(2): 119-129. DOI: 10.4097/kja.d.19.00010http://dx.doi.org/10.4097/kja.d.19.00010.

Wallace D, Cowling TE, Walker K, et al. Short- and long-term mortality after liver transplantation in patients with and without hepatocellular carcinoma in the UK [J]. Br J Surg, 2020, 107(7):896-905. DOI: 10.1002/bjs.11451http://dx.doi.org/10.1002/bjs.11451.

Xu Q, Zhu M, Li Z, et al. Enhanced recovery after surgery protocols in patients undergoing liver transplantation: a retrospective comparative cohort study [J]. Int J Surg, 2020, 78(1): 108-112. DOI: 10.1016/j.ijsu.2020.03.081http://dx.doi.org/10.1016/j.ijsu.2020.03.081.

Noba L, Rodgers S, Chandler C, et al. Enhanced recovery after surgery (ERAS) reduces hospital costs and improve clinical outcomes in liver surgery: a systematic review and meta-analysis [J]. J Gastrointest Surg, 2020, 24(4):918-932. DOI: 10.1007/s11605-019-04499-0http://dx.doi.org/10.1007/s11605-019-04499-0.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据