| 摘要: |
| 目的 评估超声在住院医师规范化培训中辅助颈内静脉穿刺教学的应用效果。方法 28名在麻醉科范化培训的非麻醉专业住院医师，在经过颈内静脉穿刺理论培训和模型上操作培训之后，每位学员分别使用解剖定位法（C组）和超声定位法（U组）分别施行颈内静脉穿刺各一例。记录首次穿刺置管成功率、总穿刺置管成功率、总穿刺置管所用时间、并发症发生率以及学员对教学的满意度和操作前的自信度。结果 与C组比较，U组首次穿刺置管成功率及总成功率较高（P<0.05）；U组从开始定位到穿刺置管成功用时（10.2±1.1）min，C组用时（11.1±1.3）min，两组比较差异无统计学意义（P＞0.05）。 C组有6例形成血肿，明显高于U组（P<0.05）；两组均无形成血气胸并发症。 对于学员问卷评分调查显示，超声辅助定位下的颈内静脉穿刺置管在教学满意度和操作自信度评分均高于解剖定位法，差异具有统计学意义（P＞0.05）。结论 超声定位在颈内静脉穿刺置管教学中的应用，比传统解剖定位教学法更加安全有效，穿刺成功率明显增高，并发症少。 |
| 关键词: 颈内静脉穿刺 超声 住院医师规范化培训 |
| DOI： |
| 投稿时间：2019-01-22修订日期：2019-02-13 |
| 基金项目: |
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| Application of Ultrasound in the Teaching of internal jugular vein puncture |
| Yin Jialin,Shi Tao |
| () |
| Abstract: |
| Objective To evaluate the effect of ultrasound in assisting the teaching of internal jugular vein catheterization in standardized resident training. Methods Twenty-eight non-anesthesiology residents who were trained in anesthesiology department，after theoretical training and model operations of internal jugular vein catheterization, underwent puncture procedure with the method of anatomic localization (group C) and ultrasonic localization (group U). The success rate of the first puncture, the success rate and the time of puncture procedure, the incidence of complications and the students' satisfaction with teaching, also the confidence score before operation were recorded. Results Compared with group C, the success rate of the first puncture and puncture procedure in group U were higher (P<0.05). There was no significant difference in the time of successful puncture between group U((10.2 +1.1) min) and group C((11.1 +1.3) min)(P＞0.05). There were 6 cases of hematoma in group C, which was significantly higher than that in group U (P<0.05). Hemopneumothorax was not occured in both groups. Questionnaire survey showed that, compared with group C, the scores of teaching satisfaction and operation confidence score of puncture procedure were higher in group U(P<0.05). Conclusion The location of ultrasound assisting in the teaching of internal jugular vein catheterization is safer and more effective than the traditional anatomic location teaching method, with a higher success rate and less complications. |
| Key words: Internal jugular vein puncture Ultrasound Standardized training of resident |
