左、右手打结训练对腹腔镜下打结操作的影响(1)
摘 要 目的：比较左、右手打结训练对腹腔镜下打结操作的影响。方法：选择2017年11月—2018年10月不同医学院校实习生32人，分为左手打结组(左手组)16人和右手打结组(右手组)16人，经临床三个阶段的培训后，比较两组培训前后腹腔镜打结时间、打结质量及打结方法得分。结果：培训前，左手组打结时间为590.50 s，少于右手组的590.50 s(P<0.05)，打结得分为2.25分，高于右手组的2.00分，但组间差异无统计学意义(P>0.05)。培训后，两组打结时间、打结得分差异均无统计学意义(P>0.05)，但均优于培训前。结论：左手打结训练对于掌握腹腔镜打结有一定的临床实践价值和指导意义。
关键词 腹腔镜术；打结；左手；右手
中图分类号：R615 文献标志码：A 文章编号：1006-1533(2019)06-0035-03
Effect of left and right hand knotting training on laparoscopic knotting operation*
WANG Huipeng， YE Tao， CHEN Jun， SHEN Chenxia， CHEN Wenjie， WU Yibin， WANG Yueqian， FENG Shaowen， SU Xianhao， ZHAO
Jiaying， CAI Yuankun**
(Department of General Surgery of the Fifth People’s Hospital affiliated to Fudan University， Shanghai 200240， China)
ABSTRACT Objective： To compare the effects of left and right hand knotting training on laparoscopic knotting operation. Methods： From November 2017 to October 1818， 32 interns from different medical colleges were selected， including 16 lefthanded knotting group (left-handed group) and 16 right-handed knotting group (right-handed group). After three stages of clinical training， laparoscopic knotting time， knotting quality and knotting method scores before and after training were compared between the two groups. Results： Before the training， the knotting time of the left-hand group was (590.50) s， which was less than that of the right-hand group (590.50) s (P < 0.05). The knotting score was 2.25 points of the left-hand group， which was higher than the 2.00 points of the right-hand group， but the difference between the groups was not statistically significant (P > 0.05). After the training， there was no statistical significance in the knotting time and the score in the right and left hand group(P > 0.05)， but they were better than those before training. Conclusion： Left hand knotting training has certain clinical value and guiding significance for mastering laparoscopic knotting.
KEY WORDS laparoscopy； knot-tying； left hand； right hand
打結为外科手术基本操作技术之一，分为单手打结、双手打结和器械打结法。单手打结根据完成打结动作的手法分为左、右手打结两种方法。国内以右手打结较为普遍，但亦有部分院校及西方国家采用左手打结。然而，左、右手打结及双手打结三种方式在打结速度、质量及手法方面缺乏相关性分析。随着微创手术时代的来临，越来越多的外科传统手术能通过腹腔镜技术完成，腔镜下手法打结也成为外科医生的基本操作技能之一[1-3]。在临床实践中，绝大多数医生习惯用右手(右利手)操作和打结，而左手打结、双手打结均能掌握者较少。本文报道对无临床操作经验的实习生进行左、右手打结训练，观察两种手法对腹腔镜打结操作的影响。
1 资料与方法
1.1 一般资料
选择2017年11月—2018年10月不同院校的实习生32人，分为A组16人(男∶女≈1∶1)，来自复旦大学附属上海市第五人民医院复旦大学公共卫生学院和皖南医学院，B组16人(男∶女≈1∶1)，来自上海交通大学附属新华医院。两组学生均为右利手，排除有临床打结或腹腔镜操作经验者、左利手者和手部功能障碍者。, 百拇医药(王会鹏 叶桃 陈骏 沈晨霞 陈文杰 吴医斌 王跃迁 冯少问 苏献豪 赵加应 蔡元)
关键词 腹腔镜术；打结；左手；右手
中图分类号：R615 文献标志码：A 文章编号：1006-1533(2019)06-0035-03
Effect of left and right hand knotting training on laparoscopic knotting operation*
WANG Huipeng， YE Tao， CHEN Jun， SHEN Chenxia， CHEN Wenjie， WU Yibin， WANG Yueqian， FENG Shaowen， SU Xianhao， ZHAO
Jiaying， CAI Yuankun**
(Department of General Surgery of the Fifth People’s Hospital affiliated to Fudan University， Shanghai 200240， China)
ABSTRACT Objective： To compare the effects of left and right hand knotting training on laparoscopic knotting operation. Methods： From November 2017 to October 1818， 32 interns from different medical colleges were selected， including 16 lefthanded knotting group (left-handed group) and 16 right-handed knotting group (right-handed group). After three stages of clinical training， laparoscopic knotting time， knotting quality and knotting method scores before and after training were compared between the two groups. Results： Before the training， the knotting time of the left-hand group was (590.50) s， which was less than that of the right-hand group (590.50) s (P < 0.05). The knotting score was 2.25 points of the left-hand group， which was higher than the 2.00 points of the right-hand group， but the difference between the groups was not statistically significant (P > 0.05). After the training， there was no statistical significance in the knotting time and the score in the right and left hand group(P > 0.05)， but they were better than those before training. Conclusion： Left hand knotting training has certain clinical value and guiding significance for mastering laparoscopic knotting.
KEY WORDS laparoscopy； knot-tying； left hand； right hand
打結为外科手术基本操作技术之一，分为单手打结、双手打结和器械打结法。单手打结根据完成打结动作的手法分为左、右手打结两种方法。国内以右手打结较为普遍，但亦有部分院校及西方国家采用左手打结。然而，左、右手打结及双手打结三种方式在打结速度、质量及手法方面缺乏相关性分析。随着微创手术时代的来临，越来越多的外科传统手术能通过腹腔镜技术完成，腔镜下手法打结也成为外科医生的基本操作技能之一[1-3]。在临床实践中，绝大多数医生习惯用右手(右利手)操作和打结，而左手打结、双手打结均能掌握者较少。本文报道对无临床操作经验的实习生进行左、右手打结训练，观察两种手法对腹腔镜打结操作的影响。
1 资料与方法
1.1 一般资料
选择2017年11月—2018年10月不同院校的实习生32人，分为A组16人(男∶女≈1∶1)，来自复旦大学附属上海市第五人民医院复旦大学公共卫生学院和皖南医学院，B组16人(男∶女≈1∶1)，来自上海交通大学附属新华医院。两组学生均为右利手，排除有临床打结或腹腔镜操作经验者、左利手者和手部功能障碍者。, 百拇医药(王会鹏 叶桃 陈骏 沈晨霞 陈文杰 吴医斌 王跃迁 冯少问 苏献豪 赵加应 蔡元)