住院医师颈内静脉穿刺置管教学中引入超声引导技术的探讨

Exploration of Introducing Ultrasound Guided Technology into the Teaching of Internal Jugular Vein Puncture and Catheterization by Resident Physicians

为探讨住院医师颈内静脉穿刺置管教学中超声引导技术的应用效果,选择无颈内静脉穿刺置管经验的第一或第二年的麻醉科住院医师共10名为研究对象,将其随机分为超声引导学习组(U组)和体表定位学习组(L组),每组5人。培训结束后,两组住院医师分别运用超声引导法和体表定位法完成25例右颈内静脉穿刺置管。记录每位住院医师颈内静脉穿刺置管情况,用累积和(Cumulative Sum,CUSUM)法绘制学习曲线,计算掌握颈内静脉穿刺置管技术所需操作的最少次数;记录两组住院医师的自信心评分;以住院医师对最后3名患者的操作作为操作考核,记录穿刺置管情况。实践证明,在颈内静脉穿刺置管教学中应用超声引导技术,住院医师学习曲线更短、更易掌握,值得在麻醉学住院医师技能操作学习中推广。

To explore the application effect of ultrasound guided technology in the teaching of internal jugular vein puncture and catheterization by resident physicians,a total of 10 anesthesiologists who had no experience in internal jugular vein puncture and catheterization in their first or second year were selected as the research subjects.They were randomly divided into ultrasound guided learning group(U group)and surface localization learning group(L group),with 5 people in each group.After the training,two groups of resident physicians completed 25 cases of right internal jugular vein puncture and catheterization adopted ultrasound guidance and body surface positioning methods respectively.Record the placement of internal jugular vein catheterization by every resident physician,draw a learning curve with the cumulative sum(CUSUM)method,and to calculate the minimum quantity of operations required to master the technique of internal jugular vein catheterization.To record resident physicians'confidence scores of two groups.Take resident physicians'operation on the last three patients as the operational assessment,then record the puncture and catheterization situation.Practice has proven that the application of ultrasound guided technology in the teaching of internal jugular vein puncture and catheterization can shorten the learning curve for resident physicians and make it easier to master.It is worth promoting in the skill learning of anesthesiology resident physicians.