不同资历医师床旁超声引导深静脉穿刺的效果观察

Observation on the Effect of Bedside Ultrasound-Guided Deep Venous Catheterization by Physicians with Different Qualifications and Records of Service

目的观察比较不同资历医师行床旁超声引导下深静脉穿刺的效果,探讨床旁超声引导对减少因资历因素导致效果差异的作用。方法选择2017年2月至2017年7月我院EICU超声引导下深静脉穿刺操作的病例71例,按操作医师资历分为规培医师组22例、住院医师组28例、主治医师组21例,比较三组的一次穿刺成功率、总成功率、首次穿刺到回血时间、首次穿刺到导丝到位时间、并发症情况等。结果在床旁超声引导下,三组均在三次尝试以内穿刺成功,均未出现并发症。三组的一次穿刺成功率、首次穿刺到回血时间、首次穿刺到导丝到位时间比较,差异均无统计学意义(P>0.05)。结论床旁超声引导下深静脉穿刺置管术能够有效提高操作效率及安全性,减少或避免资历因素的影响。

Objective To observe the effect of bedside ultrasound-guided deep venous catheterization by physicians with different qualifications and records of service, and evaluate the clinical significance of bedside ultrasound guidance on reducing effect discrepancy due to physicians＇different qualifications and record of service. Methods 71patients with bedside ultmsound-gulded venous catheterization in EICU of our hospital from February 2017 to July 2017 were selected and divided into three groups according to operators＇ qualifications, including 22 cases operated by physicians during standardized residents training, 28 cases operated by resident physicians, and 21 cases operated by attending physicians. The first puncture success rate, total success rate, time from first puncture to blood returning, time from first puncture to accurate positioning of guide wire, and complications were compared among three groups. Results With guidance of bedside ultrasound, all catheterizations were completed under three attempts and no complication occurred. No statistical difference was found among three groups in first puncture success rate, total success rate, time from first puncture to blood returning, or time from first puncture to accurate positioning of guide wire （all P 〉0.05）. Conclusions Bedside ultrasound-guided deep venous catheterization can effectively improve the operation efficiency and safety, reduce or avoid deviation due to physicians＇ qualifications and records of service~