[1]廉波*,李勍,陈彧,等.股动静脉途径插管体外膜式氧合循环辅助的学习曲线[J].中国微创外科杂志,2018,18(3):209-212.
　Lian Bo,Li Qing,Chen Yu,et al.The Learning Curve of Veno-arterial Extracorporeal Membrane Oxygenation by Femoral Vessels Cannulation[J].Chinese Journal of Minimally Invasive Surgery,2018,18(3):209-212.
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股动静脉途径插管体外膜式氧合循环辅助的学习曲线()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年3期
页码:
209-212
栏目:
临床研究
出版日期:
2018-05-01

文章信息/Info

Title:
The Learning Curve of Veno-arterial Extracorporeal Membrane Oxygenation by Femoral Vessels Cannulation
作者:
廉波*; 李勍; 陈彧; 赵舟; 高卿; 韩增强
北京大学人民医院心脏外科，北京100044
Author(s):
Lian Bo;  Li Qing;  Chen Yu;  et al.
Department of Cardiac Surgery, Peking University People’s Hospital, Beijing 100044, China
关键词:
体外膜式氧合; 股动静脉; 累积和; 学习曲线
Keywords:
Extracorporeal membrane oxygenation; Femoral vessels; Cumulative sum; Learning curve
文献标志码:
A
摘要:
目的探讨经股动静脉插管静-动脉体外膜式氧合（venoarterial extracorporeal membrane oxygenation，VAECMO）循环辅助的学习曲线。方法2007~2016年我院对37例难治性心衰行VAECMO辅助，均使用股动静脉途径插管建立ECMO辅助通路，由同一位心脏外科医生完成。选择手术时间、出血量、下肢缺血、插管部位二次切开4项指标描述学习曲线，学习曲线的描绘采用累积和（cumulative sum，CUSUM）分析法，SPSS19.0软件进行统计学分析和学习曲线拟合。结果CUSUM学习曲线的最佳拟合模型为三次方曲线，拟合优度R2=0.994，拟合方程为∑i（累积和值）=0001X3-0.136X2+3.449X-2.012，拟合曲线在手术例数累积至第16例时，三次方曲线相应点的切线斜率变为负值。结论利用CUSUM对股动静脉途径插管VAECMO循环辅助的学习曲线进行分析，术者累积手术例数达到16例时能够较好掌握此项手术技术，减少手术并发症的出现。
Abstract:
ObjectiveTo investigate the learning curve of venoarterial extracorporeal membrane oxygenation (VAECMO) by femoral vessels cannulation.MethodsA total of 37 patients with refractory heart failure who underwent VAECMO therapy in our hospital from 2007 to 2016 had been involved. The operation was performed by one cardiac surgeon. The femoral vessels cannulation was conducted. The total time of cannulation, bleeding, lower limp ischemia, and reoperation were recorded as evaluating indicators. The learning curve was indicated with the cumulative sum (CUSUM) analysis, and the curvefitting of CUSUM was designed through SPSS software. Results The CUSUM learning curve was best modeled as a thirdorder polynomial (parabola). The fitting equation was ∑i=0.001X3-0.136X2+3.449X-2.012, and the R2 value was 0.994. The curve slope turned into negative at the 16th case.ConclusionAt least 16 cases are needed for VAECMO by femoral vessels cannulation to master this technique.

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备注/Memo

备注/Memo:
*通讯作者，E-mail: lianbo_hero@163.com
更新日期/Last Update: 2018-05-10