目的 探讨不同经验水平的超声医师识别和显示深部子宫内膜异位症(deep endometriosis,DE)系统性盆腔超声评估方法的可行性,并制定学习曲线.方法 选取2023年1—3月首都医科大学附属北京妇产医院普通妇科患者.2名不同经验水平的超声医师通过学习国际DE分析组(international deep endometriosis analysis,IDEA)推荐的系统性盆腔超声检查方法,对患者进行系统性盆腔超声评估,比较2名超声医师显示盆腔结构成功率和扫查所需时间,并制定学习曲线.结果 共纳入197例患者,年龄21～45岁,平均(34.8±5.9)岁.其中,超声医师甲共检查患者98例,超声医师乙共检查患者99例.2名超声医师双侧骶韧带、滑动征、直肠前壁及输尿管下段扫查成功率的比较,差异均无统计学意义(P>0.05).各部位的扫查成功率随扫描次数的增加而增加,所需扫查时间随着扫查次数的增加而缩短.超声医师甲扫查双侧骶韧带、滑动征及双侧输尿管下段扫查所需平均时间高于超声医师乙,差异均有统计学意义(P<0.05).2名超声医师扫查成功率在第一阶段至第二阶段呈明显上升趋势,第三阶段至第五阶段区域平缓;扫查所需时间在第一阶段至第二阶段呈明显下降趋势,第三阶段至第五阶段区域平缓,即40例为学习曲线的拐点.结论 经过训练掌握系统性超声评估方法可行,通过对40例患者的操作训练,不同经验的超声医师可以基本掌握系统性盆腔超声评估方法.
Study on learning curve of systematic sonographic evaluation on deep endometriosis
Objective To explore the feasibility of attaining technique of systematic sonographic evaluation on deep endometriosis (DE) in doctors with different working experience,and to study learning curves.Methods General gynecological patients in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January to March 2023 were selected.Two sonologists with different experiences performed systematic sonographic evaluation for these patients according to the recommendation of international deep endometriosis analysis (IDEA).The success rate of displaying pelvic structure and the time required for scanning were compared between the two sonographers,and the learning curve was established.Results A total of 197 patients were consecutively enrolled in this study,aged from 21 to 45 years,with an average of (34.8±5.9) years.Ultrasound doctor A examined 98 patients and ultrasound doctor B examined 99 patients.There was no significant difference in the success rate of scanning bilateral sacral ligament,sliding sign,anterior rectal wall and lower ureter between the two sonographers (P>0.05).The scanning success rate of each part were increased with the increase of scanning times,and the required scanning time decreases with the increase of scanning times.The average scanning times of ultrasound doctor A to scan bilateral sacral ligament,sliding sign and bilateral lower ureter was longer than that for ultrasound doctor B,and the differences were statistically significant (P<0.05).The success rate of two ultrasound doctor showed an obvious upward trend from the first to the second stage,and the area was flat from the third to the fifth stage.The scanning times required for scanning showed an obvious downward trend from the first to the second stage,and the region was gentle from the third to the fifth stage,that was,40 cases were the inflection points of the learning curve.Conclusions It is feasible to conduct systematic pelvic scanning according to IDEA consensus after training.Systematic scanning technique could be attained by ultrasound doctors with different working experience after training in about 40 cases.
systematic sonographic evaluationdeep endometriosis (DE)learning curvepelvicscanning success ratescanning time
万方数据
维普
