超声引导下颈内静脉穿刺术在非麻醉住院医师规范化培训中的应用

Application of Ultrasound-Guided and Traditional Internal Jugular Vein Puncture in Non-Anesthesia Resident Standardized Training

目的:探讨超声引导下行颈内静脉穿刺术在非麻醉专业临床住院医师规范化培训中的应用。方法:选取需要进行规范化培训的非麻醉专业临床住院医师70名,采用随机数字表随机分为超声组(35名)与传统组(35名),其中超声组采用超声引导下颈内静脉穿刺教学,传统组根据动静脉毗邻的解剖位置进行穿刺教学。对2组医师进行问卷调查,并分析比较2组医师一次性穿刺成功率,穿刺完成时间,误穿动脉、气胸等并发症发生情况。结果:颈内静脉穿刺一次性穿刺成功率超声组为94. 3%,明显高于传统组的77. 1%(P <0. 05)。传统组中有3名医师穿刺时误穿到颈内动脉,超声组未发生误穿,2组医师穿刺时间无差异,2组均无发生气胸等并发症。结论:超声引导下颈内静脉穿刺术运用于非麻醉专业住院医师规范化培训教学中,能使住院医师熟练掌握颈内静脉穿刺的技能,提高穿刺成功率,值得推广。

[Objective]To investigate the application of ultrasound-guided internal jugular vein puncture in non-anesthesia resident standardized training. [Method] 70 non-anesthesia standardized training clinical residents were randomly divided into two groups: ultrasound group and traditional group. The ultrasound group was received ultrasound-guided teaching of internal jugular vein puncture, while the traditional group was taught with traditional teaching methods to puncture according to the anatomical position.The success rate of one-time puncture, the completion time of puncture, and the complications of arterial and pneumothorax were observed in two groups of physicians. [Result] The success rate of one-time puncture in the traditional group was 77.1%, and that in the ultrasound group was 94.3%, which was significantly higher than that in the traditional group(P<0.05). Three students in the traditional group punctured internal carotid artery, while the ultrasound group did not. There was no difference in puncture time between the two groups, and there were no complications such as pneumothorax in the two groups.[Conclusion] Ultrasound-guided jugular vein puncture, used in the teaching of non-anesthesia resident standardization training, can enable clinicians to master the skills of jugular vein puncture and is worthy of clinical teaching promotion.