儿科体外膜肺氧合支持团队规范化培养模式的实践

Exploration and Practice of Standardized Training on Pediatric Extracorporeal Membrane Oxygenation Support Team

目的 探索高效的儿科体外膜肺氧合支持团队规范化培养模式,以匹配日益发展的儿童重症医学对儿童重症医师/护士掌握高级生命支持能力的要求。方法 对2015年1月1日-2019年12月31日国内38个接受ECMO培训的儿科医疗团队采取临床实践教学、全真模拟教学及两者结合的教学模式,通过培训考核、问卷调查比较3种培养模式的教学效果。结果 参加模式三培训的医师数为26(13,36)人显著高于另2种模式;3种教学模式培训考核通过率均为100%;3种教学模式培养的团队对是否开展ECMO、ECMO例数、病死率、是否进行ECMO转运无显著差异,但接受模式三培训的团队完成新生儿ECMO例数为1(1,5)人显著增多,差异具有统计学意义。结论 3种培养模式均切实可行,能够有效提升儿科体外膜肺氧合支持医师/护士的岗位胜任能力,促进儿科ECMO技术在国内的顺利开展。

Objectives With the rapid development of pediatric intensive care medicine,we aim to find an effect standardized training on pediatric extracorporeal membrane oxygenation support team to meet the comprehensive requirement for pediatric intensive care physicians/nurses to master advanced life support capabilities.Methods 38 domestic pediatric medical teams were divided into three groups according to different teaching methods,such as clinical practice teaching,true simulation teaching and a combination of the two teaching modes from January 2015 to December 2019.Then we compare the teaching effects of the three training modes by training assessment and questionnaire survey.Results There were no statistically significant differences among the three teaching modes in hospital type,leading departments,number of beds,number of nurses,number of doctors/beds,and number of nurses/beds.The number of doctors 26(13,36) participating in mode three is significantly higher than the other two modes.The pass rate of three teaching modes is 100%.The teams trained in the three teaching models showed no significant differences in whether ECMO was carried out,the number of ECMO cases,the fatality rate,and whether ECMO was carried out or not,but the number of neonatal ECMO cases1(1,5) that accepted the third mode was significantly increased.Conclusions Pediatric ECMO training could improve pediatricians’ understanding and application of ECMO technology.Furthermore,the training course could improve the regional ability of treatment for critically ill children and promote the development of application of pediatric ECMO technology.