髋关节镜手术入路建立的学习曲线分析△

Learning curve analysis of portal establishment in hip arthroscopy

摘要:

[目的]探讨髋关节镜手术入路的建立，总结学习曲线与经验，为初学者提供参考。[方法]2016 年 5 月—2019 年 2 月， 作者开展髋关节镜手术 50 例，采用前外侧入路(anterolateral approach, AL)和中前辅助入路(mid-anterolateral portal, MA)。[结果] 随手术病例的积累，20 例以后建立 AL 手术入路的时间显著下降 (P＜0.05)；学习曲线趋于平稳，差异无统计学意义 (P＞ 0.05)。MA 入口建立所需时间也显著下降(P＜0.05)；学习曲线在 35 例以后才趋于平稳(P＞0.05)。[结论]手术入路的建立是髋关节镜学习的重要环节，前外侧入路的建立相对容易，中前辅助入路是髋关节镜手术入路的难点，需要＞35 例手术方可完成学习曲线。

Abstract:

[Objective] To retrospectively analyze the author's initial cases of hip arthroscopy, and summarize the learning curve expe- rience for portal establishment, so as to provide a reference for the beginners. [Methods] From May 2016 to February 2019, 50 patients had hip arthroscopy performed consecutively, and the time consumed for establishment of anterolateral approach (AL) and mid- anterolateral portal (MA) were recorded. [Results] With the accumulation of cases, the time required for AL establishment decreased significantly (P＜ 0.05) , which in term of the learning curve tended to be stable after 20 initial cases, and became not statistically significant (P＞0.05) . In ad- dition, the elapsed time for MA establishment decreased significantly as case number accumulation (P＜0.05), however, the learning curve leveled off after the 35th case (P＞0.05) . [Conclusion] The establishment of portals is one of the key points of hip arthroscopy learning, and the establishment of anterolateral portal is relatively easy, while the mid-anterolateral portal is difficulty, requiring 35 cases to complete the learning curve.