不同年资的介入医生冠状动脉造影狭窄程度判断结果产生差异原因分析

Analysis of the reasons for the differences in the results of coronary angiography stenosis degree judgment among interventional physicians with different seniority

目的探讨不同年资介入医生对于冠状动脉(冠脉)造影狭窄程度分析的差异。方法入选2018年12月至2019年12月于天津医科大学总医院和北京安贞医院心血管内科学习或从事冠状动脉粥样硬化性心脏病(冠心病)介入治疗的医生,按参加介入工作年资分为高年资组和低年资组,调查两组人员对接受冠脉造影检查的127例患者进行冠脉造影狭窄程度评估。结果研究入选82名医生,其中低年资组41人,高年资组41人。两组医生对于正常冠脉、冠脉狭窄≤50%、80%~90%、95%和99%结果判断低年资介入医生的识别率与高年资介入医生的识别率比较无明显差异(P>0.05);而两组医生对于冠脉狭窄在50%~75%及100%结果判断方面,低年资介入医生对于病变程度的认知能力与高年资介入医生存在差异(P<0.05)。结论不同年资介入医生对于冠脉狭窄程度判断存在差异,建议进行计算机建模,促使图像狭窄程度评价一致性,可提高低年资医生对于病变识别的准确度。

Objective To investigate the difference of stenosis degree analysis of coronary angiography between interventional doctors with different years of seniority.Method Doctors who studied or engaged in coronary intervention in the Department of cardiovascular medicine of Tianjin Medical University General Hospital and Beijing Anzhen Hospital from December 2018 to December 2019 were selected.They were divided into high seniority group and low seniority group according to different years of intervention work.The personnel of the two groups were investigated to evaluate the stenosis degree of coronary angiography in 127 patients undergoing coronary angiography.Result 82 doctors were selected,including 41 in the low seniority group and 41 in the high seniority group.There was no significant difference between the recognition rate of low seniority interventional doctors and high seniority interventional doctors(P>0.05);However,there were significant differences between the two groups in the judgment of 50%~75%and 100%results of coronary artery stenosis between the junior interventional doctors and the senior interventional doctors(P<0.05).Conclusion There are differences in the judgment of the degree of coronary artery stenosis by interventional doctors with different years of experience.Computer modeling is suggested to promote the consistency of image stenosis evaluation,which can improve the accuracy of lesion recognition by junior doctors.