真空辅助旋切活检系统治疗乳腺良性肿物学习曲线研究

Study on the Learning Curve of Vacuum Assisted Rotary Biopsy System in the Treatment of Benign Breast Masses

摘要: 目的：研究超声引导下真空辅助微创旋切活检系统(Vacuum assisted biopsy, VAB)治疗乳腺良性肿物的学习曲线。方法：本文为前瞻性研究，选择我院2019年1月至2021年8月乳腺外科收治的需要微创治疗的乳腺良性肿物患者61例，由同一名医师独立完成手术，采用CUSUM法进行学习曲线分析，从而得出VAB学习曲线拐点，分为学习提高和熟练掌握两个阶段，然后对比两阶段的基线资料、手术情况、术后不同时间疼痛评分、术后满意度和术后并发症发生情况及残留率，分析研究真空辅助旋切活检系统治疗乳腺良性肿物的学习曲线。结果：学习曲线的拐点在24例，完成学习曲线后，可以明显缩短手术时间，减少出现量，降低术后疼痛评分，减少术后并发症，提高患者满意度，差异有统计学意义，但是在残留率方面，两阶段差别无统计学意义。结论：对于超声引导下真空辅助乳腺微创旋切术，一名青年医师在24例后可熟练掌握该术式，减少手术并发症，获得较高的满意率。

Abstract: Objective: To study the learning curve of ultrasound guided vacuum assisted biopsy (VAB) in the treatment of benign breast tumors. Methods: This article is a prospective study. 61 patients with benign breast tumors requiring minimally invasive treatment who were admitted to breast surgery in Pingdu Maternal and Child Health Hospital from January 2019 to August 2021 were selected, and the same physician independently completed the surgery. CUSUM method was used for learning curve analysis to obtain the inflection point of the VAB learning curve, which was divided into two stages: learning improvement and proficient mastery. Then, baseline data and surgical conditions of the two stages were compared, pain scores, postoperative satisfaction, postoperative complica-tions, and residual rates at different times after surgery were analyzed to study the learning curve of vacuum assisted rotary biopsy system in the treatment of benign breast tumors. Results: The in-flection point of the learning curve was found in 24 patients. After completing the learning curve, it could significantly shorten the operation time, reduce the occurrence, reduce the postoperative pain score, reduce postoperative complications, and improve patient satisfaction. The difference was statistically significant, but in terms of residual rate, the difference between the two stages was not statistically significant. Conclusion: For ultrasound-guided vacuum assisted minimally invasive circumcision of the breast, a young physician can skillfully master the operation after 24 cases, re-duce surgical complications, and achieve a high satisfaction rate.