术前热身运动对腹腔镜妇科手术的影响--一项随机试验

术前热身运动对腹腔镜妇科手术的影响--一项随机试验
Effect of Preoperative Warm-up Exercise Before Laparoscopic Gynecological Surgery- A Randomized Trial

Abstract
摘要
BACKGROUND:
背景：
Laparoscopic surgical procedures require a high level of cognitive and psychomotoric skills. Thus, effective training methods to acquire an adequate level of expertise are crucial. The aim of this study was to investigate the effect of preoperative warm up training on surgeon׳s performance during gynecologic laparoscopic surgery.
腹腔镜手术需要高水平的认知和精神运动技能。因此，有效的培训方法，以获得足够的专业知识是至关重要的。本研究的目的是探讨术前热身训练的外科医生׳妇科腹腔镜手术中性能的影响。

MATERIALS AND METHODS:
材料与方法：
In this randomized controlled trial, surgeons performed a preoperative warm up training using a virtual reality simulator before laparoscopic unilateral salpingo-oophorectomy. Serving as their own controls, each subject performed 2 pairs of laparoscopic cases, each pair consisting of 1 case with and 1 without warm up before surgery. Surgeries were videotaped and psychomotoric skills were rated using objective structured assessment of technical skills (OSATS) and the generic error rating tool by a masked observer. Perioperative complications were assessed. Statistical analysis was performed using a mixed model, and mean OSATS scores were compared between both the groups.
在这项随机对照试验中，外科医生进行术前的热身训练使用虚拟现实模拟器在腹腔镜单侧输卵管卵巢切除术。作为自己的控制，每一个受试者进行2对腹腔镜的情况下，每对组成的1例和1例，术前没有热身。手术录像和精神运动技能被评为使用目的的结构化评估技能（osats）和通用的错误评级工具由一个不明的观察员。围手术期并发症进行了评估。统计分析采用混合模型进行比较，平均两组之间osats评分。

RESULTS:
结果:
In total, data of 10 surgeons and 17 surgeries were available for analysis. No differences between educational level and surgical experiences were observed between the groups. Mean standard error psychomotoric and task-specific OSATS scores of 19.8 (1.7) and 3.7 (0.2) were observed in the warm up group compared with 18.6 (1.7) and 3.8 (0.2) in the no warm up group, respectively (p = 0.51 and p = 0.29). Using generic error rating tool, the total number of errors was 8.75 (2.15) in the warm up group compared with 10.8 (2.18) in the no warm-up group (p = 0.53). Perioperative complications and operating time did not differ between both the groups.
总共有10名外科医生和17个手术的数据进行分析。组之间无显着差异，教育水平和手术经验之间的组。平均标准误差下心理和任务的具体osats得分19.8（1.7）和3.7（0.2）在热身组相比18.6观测（1.7）和3.8（0.2）在没有热身组，分别为（P = 0.51，P = 0.29）。使用通用的错误评估工具，错误的总数为8.75（2.15）在热身组相比，10.8（2.18），在没有热身组（P = 0.53）。围手术期并发症和手术时间没有显着差异有两组。

DISCUSSION:
讨论：
The present study suggests that warm-up before laparoscopic salpingo-oophorectomy does not increase psychomotoric skills during surgery. Moreover, it does not influence operating time and complication rates. (Medical University of Vienna-IRB approval number, 1072/2011, ClinicalTrials.gov number, NCT01712607).
目前的研究表明，在腹腔镜输卵管卵巢切除术不在手术过程中增加精神运动技能热身。此外，它不影响手术时间和并发症发生率。（维也纳大学医学院的IRB批准号，1072 / 2011，ClinicalTrials.gov，nct01712607）。

KEYWORDS:
关键词：
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; computer-simulation; laparoscopic training; salpingo-oophorectomy; training; warm-up
医学知识；病人护理；基于实践的学习与提高；计算机仿真；腹腔镜培训；输卵管卵巢切除术；训练；热身

原文：
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