TTR-way在宫颈癌筛查及阴道镜诊断培训中的价值研究

摘要

Objective To evaluate the value of TTR-way in the training of cervical cancer screening and colposcopy diagnosis.Methods Retrospectively analyze the.training outcome among the 93 trainees who attended the training sessions during the period from April to October 2015;compare the coincidence rates of colposcopy diagnosis results before and after the training with paired T test;collect trainee information through questionnaires,and search for the possible factors that affect the coincidence rates using generalized linear models.Results The research covered 94 questionnaires.The average coincidence rate of colposcopy diagnosis results before training was (63.30± 13.07)％,while the coincidence rate after training was (78.28±7.37)％;the paired T test indicated the variances (T=9.59;P＜0.001) had statistical significance;multi-factor analysis result suggested whether the trainee attended other colposcopy diagnosis and evaluation training or not affected the coincidence rate before training,but training session time,education background,professional title,practice experience in colposcopy diagnosis and hospital level had no impact on either the coincidence rate before training or the average rangeability of coincidence rate (average P ＞0.05);for trainees whose coincidence rates before training were within "≥75％","65％-＜ 75％","55％-＜ 65％" and "＜55％",their variances of coincidence rate after training(F=l.86;P=0.1416)had no difference.Conclusion After the TTR-way training,the coincidence rates of colposcopy diagnosis results have significantly improved,and the trainees’ competence for colposcopy diagnosis varies little.Thus,TTR-way software is applicable to gynecogical and obstetrical doctors from all educational background,all levels of hospitals and with varying professional titles.%目的 评估R-way阴道镜培训软件(TTR-way)在宫颈癌筛查及阴道镜诊断培训中的价值.方法 回顾性分析2015年4-10月于北京大学第一医院参加TTR-way培训的94名学员的培训效果,采用配对t检验比较培训前后的符合率(阴道镜诊断结果);采用广义线性模型探讨影响学员R-way阴道镜诊断符合率的可能因素.结果学员培训前的阴道镜拟诊平均符合率为(63.30±13.07)％,培训后的平均符合率为(78.28±7.37)％,差异有统计学意义(P＜0.001);多因素分析结果显示,“是否参加过其他阴道镜培训”影响培训前符合率,而培训期别、学员学历、技术职称、从事阴道镜工作的时间、医院等级对培训前符合率和符合率变化幅度均无影响(P均＞0.05);培训前符合率为“≥75％”、“65％～＜ 75％”、“55％～＜ 65％”、“＜55％”的4组学员,培训后符合率差异无统计学意义(F=1.86,P=0.1416).结论 通过培训,学员阴道镜拟诊符合率显著提高且诊断水平较为一致.TTR-way适于在缺乏阴道镜经验的各等级医院、各种学历、各技术职称的妇产科医生中推广.