精准医学杂志2024，Vol.39Issue(5)：435-438,443,5.DOI:10.13362/j.jpmed.202405014
机器人辅助下二尖瓣置换术学习曲线临界值的确定及意义
Determination and significance of the learning curve threshold for robot-assisted mitral valve replace-ment
摘要
Abstract
Objective To investigate the learning curve threshold for robot-assisted mitral valve replacement,and to pro-vide guidance for clinical practice.Methods A retrospective analysis was performed for the clinical data of 37 patients who un-derwent robot-assisted mitral valve replacement in Department of Cardiovascular Surgery in our hospital from December 2014 to December 2017,and the patients were ordered based on date of surgery.The cumulative sum(CUSUM)was calculated for time of operation,duration of cardiopulmonary bypass(CPB),and aortic cross-clamp time,and the CUSUM learning curve was modeled by curve fitting.The patients were divided into two groups based on the highest CUSUM of time of operation,and the two groups were compared in terms of general information,time of operation,duration of CPB,aortic cross-clamp time,total drainage volume(the sum of retrosternal drainage volume and thoracic drainage volume)during the 3 days before surgery,length of hospital stay,use of drugs and blood products in the perioperative period,and whether secondary thoracotomy was performed.Results The fitting curve reached the top at the 9th case on the time of operation,and the highest numbers of CPB and aortic cross-clamp time were 12 and 11,respectively.The patients were divided into two groups at the 9th case,and there were significant differences be-tween the two groups in total drainage volume and the amount of red blood cell and plasma used after surgery on days 2 and 3(Z=2.21-2.55,P＜0.05).Conclusion The minimum number of cases is 9 for robot-assisted mitral valve replacement to develop from the learning stage to the proficiency stage.Changes in patient conditions should be closely monitored during the learning stage to actively improve their prognosis.关键词
机器人手术/心脏瓣膜假体植入/二尖瓣成形术/学习曲线/时间因素/预后Key words
Robotic surgical procedures/Heart valve prosthesis implantation/Mitral valve annuloplasty/Learning curve/Time factors/Prognosis分类
医药卫生引用本文复制引用
栾同晓,聂卫红,王荣梅,张宏,吴玉辉,杨苏民..机器人辅助下二尖瓣置换术学习曲线临界值的确定及意义[J].精准医学杂志,2024,39(5):435-438,443,5.基金项目
国家自然科学基金青年科学基金项目(81700247) （81700247）
