北京地区医护人员对骨髓腔内输液知晓现况的调查研究

Status quo study of the medical staffs in intraosseous infusion in Beijing area

目的对北京地区部分三级甲等医院的医护人员进行调查,了解其对急症静脉输液方式的知晓现况,分析目前我国骨髓腔内输液应用不足的原因,为制订普及骨髓腔内输液技术的具体方案提供依据。方法选择北京地区8家三级甲等医院急诊科、重症监护室和其他科室的临床医护人员共420人为调查对象,通过调查问卷方式统计分析其对骨髓腔内输液及中心静脉输液的知晓情况、信任度等情况。结果本研究入选的医护人员对骨髓腔内输液的知晓率为32.6%(137/420),而中心静脉输液知晓率为97.4%(409/420);知晓骨髓腔内输液适应证和操作流程者分别占4.0%(17/420)和3.8%(16/420),知晓骨髓腔内输液禁忌证者占22.6%(95/420);信任骨髓腔内输液者占49.5%(208/420)。其他科室(主要为心血管内科)医护人员骨髓腔内输液知晓率[26.9%(52/193)]低于急诊科[40.8%(42/103)](P<0.05);不同职称医护人员骨髓腔内输液知晓率存在显著差异(P<0.05),其中急诊科和重症监护室的医护人员骨髓腔内输液知晓率由初级职称至高级职称呈升高趋势(分别:P=0.002,P<0.001)。其他科室高级职称医护人员骨髓腔内输液知晓率[31.7%(13/41)]低于重症监护室[72.7%(8/11)]和急诊科[66.7%(4/6)]同级别医护人员。当周围静脉2次穿刺均不成功时,70.7%(297/420)的医护人员考虑中心静脉输液,22.1%(93/420)的医护人员选择再尝试,仅有4.1%(17/420)的医护人员考虑骨髓腔内输液。调查的8家三级甲等医院中目前仅1家医院正在开展骨髓腔内输液技术。结论骨髓腔内输液技术在我国医护人员中的知晓率及其在医院的开展率极低,亟待加强相关知识的宣传和培训。

Objective To investigate the condition of awareness of emergency intravenous infusion style in medical staffs in part of third-grade class-A hospital in Beijing area, analyze the causes of insufficient of intraosseous infusion in China, to provide the basis for the development of the intraosseous infusion technology. Method 420 clinical medical staffs in emergency department, ICU and other departments in 8 hospitals in Beijing area, cognitive situation and the degree of trust about intraosseous infusion and central venous infusion were counted and analyzed through questionnaire. Result Awareness rate of intraosseous infusion was only 32.6%（137/420） in medical staffs, and awareness rate of central venous infusion was 97.4%（409/420）. The indications and the operation process of intraosseous infusion were known by only 4.0%（17/420） and 3.8%（16/420） in the medical staff; and the contraindications of intraosseous infusion were known by 22.6%（95/420）. There were only 49.5%（208/420） medical staffs trust the intraosseous infusion. The average awareness rate of intraosseous infusion in the medical staffs of the other department [26.9%（52/193）] was less than that in emergency department [40.8%（42/103）]（P〈0.05）; the awareness of intraosseous infusion from junior titles to senior titles tended to increase especially in emergency department and ICU, trend test had statistically significant difference（respectively, P = 0.002, P〈0.001）; the awareness rate of intraosseous infusion among senior medical staffs in different departments was also different, the analysis found the awareness rate of intraosseous infusion in the senior medical staffs of other department [31.7%（13/41）] was less than that in the senior staffs of ICU [72.7%（8/11）] and emergency department [66.7%（4/6）]; when the peripheral venous puncture are not successful twice, 70.7%（297/420） of the medical staffs would consider central venous infusion, 22.1%（93/420） would try the peripheral venous puncture again, only 4.1%（17/420） of the medical staffs would try the way of intraosseous infusion. And this technology was started only in 1 hospital among the total 8 hospitals. Conclusion The awareness rate of intraosseous infusion in Chinese medical staffs and carry-out rate in the hospital is very low, it is urgent to strengthen the relevant knowledge propaganda and training.