摘要
目的 探讨可视化技术在麻醉学住院医师规范化培训中的应用效果。方法 将50名接受住院医师规范化培训的临床医师随机分为对照组和可视组进行临床麻醉教学，每组25人。对照组采用传统喉镜进行气管内插管教学，以及采用传统“盲穿”法进行股静脉穿刺置管教学；可视组采用可视喉镜进行气管内插管教学，以及采用超声引导技术进行股静脉穿刺置管教学。教学后2组学员分别对模拟人进行实训以及对患者进行临床实践。记录各组完成操作所用时间、成功率和并发症发生率，并绘制相应学习曲线。采用Graph Pad Prism 6进行统计分析，组间数据比较采用t检验或r检验。结果 对照组和可视组学员对模拟人完成气管内插管时间分别为（45．1±16．3）s、（32．8±13．4）s（P〈0．05），且可视组学匀曲线下降较快。对照组和可视组学员对患者的气管内插管时间分别为（44．1±10．1）s、（36．7±9．8）s（P〈0．05），可视组口腔内出血及术后咽痛等并发症发生率显著低于对照组（P〈0．05）。对照组和可视组学员完成股静脉穿刺置管时间分别为（11．7±2．4）min、（10．6±2．5）min（P〈0．05）；而对照组穿刺成功率为76．8％、可视组为89．6％（P〈0．05），且可视组误穿动脉发生率显著低于对照组（P〈0．05）；可视组学习曲线下降较对照组快。结论 可视化技术为麻醉学住院医师规范化培训提供了安全有效的教学手段和方法，具有广阔的应用前景。
Objective To explore the applicative effects of visualization techniques in clinical education of anesthesia resident standardizing training. Methods A total of 50 physicians who were receiv- ing resident standardizing training were recruited. They were randomly divided into the control group and visualization group with 25 residents each. The control group was taught to perform intratracheal intubation, using traditional laryngoscope and to perform indwelling catheter via femoral vein puncture, using traditional ＂blind puncture＂ method. The visualization group was taught to perform intratracheal intubation, using visual laryngoscope and to perform indwelling catheter via femoral vein puncture through ultrasound guidance method. Both groups conducted training on anthropomorphic dummy and patients. The operating time, success rates and incidence of complication were recorded. Learning curves were also graphed. GraphPadPrism 6 was used for statistical analysis. Data compared between groups were analyzed by t test and χ^2 test. Results The time of intratracheal intubating on anthropomorphic dummy in control group was （45.1 ± 16.3） s and that in visualization group was （32.8 ± 13.4） s （P〈0.05）. The learning curve decreased more quickly in visualization group. The time of intratracheal intubating on patients in control group was （44.1 ± 10.1） s and that in visualization group was （36.7 ± 9.8） s （P〈0.05）. Rates of complications such as oral bleeding and postoperative sore throat was lower in visualization group （P〈0.05）. The femoral catheterization time of control group was （11.7 ± 2.4） min and that of visualization group was （10.6 ± 2.5） rain （P〈0.05）. The success rate of control group was 76.8% and that of visualization group was 89.6% （P〈0.05）. Furthermore, the rate of inadvertent arterial puncture was lower in visualization group （P〈0.05）, and the learning curve decreased more quickly in visualization group. Conclusion Visualization techniques can provide an effec- tive teaching method for anesthesia resident standardizing training and has broad prospects in application.
作者
严佳
王欣倍
胡蓉
黄燕
姜虹
Yah Jia;Wang Xinbei;Hu Rong;Huang Yan;Jiang Hong(Department of Anesthesiology,Shanghai Ninth People＇s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China（Tan Jia,Hu Rong,Huang Yan,Jiang Hong;Offtce of Resident Stan-dardizing Training Administration,Shanghai Ninth People＇s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China（Wang Xinbei)
出处
《中华医学教育探索杂志》
2018年第8期839-843,共5页
Chinese Journal of Medical Education Research
基金
上海交通大学医学院医学教育研究项目（YB170711）
上海市优秀学术带头人计划（16XD1401800）
关键词
可视化技术
住院医师
麻醉学
规范化培训
Visualization techniques
Resident
Anesthesiology
Standardizing training
作者简介
通信作者：姜虹，Email：dr_hongjiang@163．com
