超声心动图四切面法在麻醉学住院医师规范化培训教学工作中的实效性探索研究

Effectiveness of echocardiography teaching in the standardized training of anesthesiology residents: An exploratory study

目的评价心脏超声心动图四个基本切面法教学在麻醉学住院医师规范化培训教学过程中的有效性。方法选择参加南方科技大学第一附属医院住院医师规范化培训的在院住院医师作为研究对象。利用超声心动图标准切面的4个基本切面(左室流入流出道、右室流入流出道、左室短轴切面、心尖四腔心切面)对住院医师进行培训,根据参加培训的次数将住院医师分为3组(31名):空白组(未参加培训,7名)、对照组(参加1次培训,10名)、实验组(参加>1次培训,14名)。观察各组住院医师在不同年级的分布情况。记录利用模型评价准确采集4个基本切面的人数,记录全部及50%正确诊断6个围手术期低血压临床模拟病例(包括心力衰竭、心包填塞、血容量不足、主动脉瓣严重狭窄、主动脉夹层、左室前壁运动异常)的人数。结果各组住院医师在不同年级的分布情况差异无统计学意义(P>0.05)。实验组正确采集4个基本切面的住院医师人数多于对照组(P<0.05);各组临床模拟病例全部做出正确诊断的人数差异无统计学意义(P>0.05);实验组50%病例正确诊断人数高于对照组(P<0.05)。结论住院医师接受两次培训后,采集超声心动图4个基本切面图像的正确率更高。利用超声心动图进行围手术期低血压模拟病例病因学诊断的准确率更高。

Objective To evaluate the effectiveness of echocardiography teaching in the standardized training of anesthesiology residents.Methods Residents in the First Affiliated Hospital,Southern University of Science and Technology who took part in standardized training were selected.They were trained on the basis of four basic views,including left ventricular in‑flow and out‑flow tract,right ventricular in‑flow and out‑flow tract,left ventricular short axis and apical four‑chamber view.According to the times of training,the residents were divided into three groups:a blank group(without being trained,n=7),a control group(being trained once,n=10)and an experiment group(being trained more than once,n=14).The distribution of residents in each group was observed.The number of people whose four basic views were accurately collected by a model was recorded.The number of people who were all or 50%correctly diagnosed with one of six types of clinically simulated hypotension during the perioperative period(including heart failure,pericardial tamponade,insufficient blood volume,severe aortic stenosis,aortic dissection,and abnormal left ventricular anterior wall motion)were recorded.Results There was no statistical difference in the distribution of residents in each group on different grades(P>0.05).The number of residents in the experiment group who correctly collected four basic views was higher than that in the control group(P<0.05).There was no statistical difference in the number of people who were correctly diagnosed in each group(P>0.05).The number of 50%correctly diagnosed patients in the experiment group was higher than that in the control group(P<0.05).Conclusions After training twice,residents can collect four basic views of echocardiography with a higher accurate rate.Echocardiography can be adopted to diagnose perioperative hypotension simulation cases,with a higher accurate rate.