颅内动脉瘤介入治疗的多模式阶段培训结果调查

Survey of multi-model stage training results for interventional treatment of intracranial aneurysms

目的评估颅内动脉瘤血管内介入治疗多模式阶段培训的效果。方法 2014年9月至2016年3月,首都医科大学宣武医院神经外科共接收26名针对出血性脑血管病培训的进修医师,学员均来自于全国三甲以上医院的神经外科。在为期1年的四阶段临床培训过程中,采用多模式教学方式,在基础理论、操作技能、专题讲座、继续教育及科研论文写作等方面,加强进修医师相关的理论和技能学习。进修医师培训结束即进行统一的笔试和技能考核,以百分制计分,≥85分为优秀。在培训结束学员返回原单位工作12个月后,以问卷形式,对26名进修医师介入治疗技能进行回访调查。结果 26名学员均顺利通过结业考核,其中22名(84.6%)学员成绩优秀。在培训后的12个月内,学员均能熟练的独立完成脑血管造影诊断操作,16名(61.5%)学员能够独立完成动脉瘤的栓塞治疗,25名学员(96.2%)能够进行围手术期的相关处理。结论在颅内动脉瘤介入治疗培训方面,多模式阶段培训取得良好的效果,进修医师的理论基础和实际操作能力显著进步,但训练模式仍需进一步完善。

Objective To evaluate the effect of multi-mode staged training program for endovascular treatment of intracranial aneurysm. Methods From September 2014 to March 2016,a total of 26 refresher neurosurgeons for hemorrhagic cerebrovascular disease were trained in the department of neurosurgery,Xuanwu Hospital,Capital Medical University. They all came from the hospitals at the level of Grade Ⅲor above in China. During the 4-stage 1 2-month clinical training process,they were trained with multi-mode teaching methods. The basic theory,operative skills,special lectures,continuing education and writing paper of scientific research were included to provide the refresher doctors with more experience of intensive study. A unified written examination and skill assessment were conducted before completion of the training. The examination was scored by the percentage system,≥85 was excellent. A questionnaire survey was conducted to investigate the independent working condition of 26 refresher doctors at 12 months after they returned to their working position. Results All of 26 trainees passed the final examination,among them 22（ 84. 6 %） had excellent grades. In the 12 months after the training,they could complete the diagnostic cerebral angiography independently; sixteen（ 61. 5%） could complete the embolization aneurysms independently and 25（ 96. 2%） were able to perform the perioperative management. Conclusion Multi-mode staged training program has achieved good effect in the training of interventional therapy for intracranial aneurysm. The theoretical basis and practical skills of the refresher doctors have been improved. But it still needs to be further improved.