超声医师对胆道闭锁了解程度调查分析

Investigation and analysis of ultrasound physicians'understanding of biliary atresia

目的了解目前中国超声医师对胆道闭锁患儿的诊断水平并探究其影响因素。方法于2021年11月6日至12月12日开展互联网问卷调查研究,将在线网络问卷通过微信群发放给全国的超声医师群体。问卷内容包括调查对象基本信息、胆道闭锁相关临床及超声知识、对胆道闭锁认知程度3个部分,采用描述性分析和通过广义线性模型分析超声医师对胆道闭锁患儿临床处理水平及超声诊断能力的影响因素。结果共收到511份有效问卷。64.77%(331/511)超声医师否认自己基本掌握胆道闭锁的超声诊断要点,分析表明医院级别较低(β=-0.344,P=0.002)、非儿科医院(β=-0.747,P=0.004)以及工作年限<15年(β=0.952,P<0.001)的超声医师对胆道闭锁的诊断掌握程度较低。当遇到疑似病例时,仅5.48%(28/511)的超声医师对自身诊断能力完全有信心。低级职称医师(β=-0.572,P<0.001)及既往没有遇到过疑似胆道闭锁患儿(β=-0.693,P<0.001)会降低超声医师诊断胆道闭锁的信心。胆道闭锁相关临床及超声问题中,仅3.33%(17/511)超声医师完全了解超声检出肝门纤维斑块对胆道闭锁的诊断意义。结论超声医师对胆道闭锁认识程度及诊断信心不足,诸多现实因素如医院级别、工作年限、职称等直接影响超声医师的诊断能力,提高超声医师胆道闭锁的认识及诊断水平势在必行。

Objective To elucidate the current proficiency level in diagnosing pediatric biliary atresia among Chinese sonographers and to identify contributing factors that may influence their diagnostic capabilities.Methods A cross-sectional internet-based survey was conducted from November 6,2021,to December 12,2021.The online questionnaire was disseminated to a national cohort of sonographers via WeChat groups.The survey encompassed three domains:demographic data of the participants,clinical and ultrasonographic knowledge pertaining to biliary atresia,and the cognitive understanding of biliary atresia.Descriptive statistics were utilized for the evaluation of demographic information and sonographers'clinical and ultrasonographic comprehension concerning biliary atresia.A generalized linear model was employed to ascertain the determinants influencing sonographers'expertise in clinical management and ultrasonographic diagnosis of biliary atresia.Results A total of 511 valid responses were collated.Approximately 64.77%(331/511)of sonographers indicated a lack of comprehensive understanding of the essential parameters for ultrasonographic diagnosis of biliary atresia.Regression analysis revealed that sonographers affiliated with lower-tier hospitals(β=-0.344,P=0.002),non-pediatric institutions(β=-0.747,P=0.004),and those with less than 15 years of professional experience(β=0.952,P<0.001)exhibited diminished proficiency in diagnosing biliary atresia.Upon encountering suspected cases,a mere 5.48%(28/511)of sonographers expressed complete confidence in their diagnostic capabilities.Lower professional grade(β=-0.572,P<0.001)and lack of prior experience with suspected cases of biliary atresia(β=-0.693,P<0.001)contributed to reduced diagnostic self-assurance among sonographers.Regarding the clinical and ultrasonographic intricacies associated with biliary atresia,only 3.33%(17/511)of sonographers had a full understanding of the diagnostic significance of hepatic fibrous plaques on ultrasound for biliary atresia.Conclusion The study underscores a pervasive inadequacy in the understanding and diagnostic confidence among sonographers in relation to pediatric biliary atresia.Various pragmatic factors,including hospital tier,years of experience,and professional ranking,exert a direct impact on the sonographers'diagnostic acumen.Given these findings,there is an exigent need for targeted educational initiatives to enhance the diagnostic proficiency in biliary atresia among sonographers.