模拟培训在急诊中心静脉置管培训中的应用

基础医学与临床 ›› 2018, Vol. 38 ›› Issue (2): 269-271.

模拟培训在急诊中心静脉置管培训中的应用

刘安雷¹,刘聚源²,徐军¹,刘继海³,朱华栋⁴,于学忠⁴

1. 北京协和医院
2. 北京医院
3. 北京协和医院急诊科
4. 中国医学科学院北京协和医学院北京协和医院急诊科

收稿日期:2017-11-15 修回日期:2017-12-18 出版日期:2018-02-05 发布日期:2018-01-24
通讯作者: 于学忠 E-mail:yxz@medmail.com.cn

Application of simulation training for central venous catherteriazation in emergency depatment

Received:2017-11-15 Revised:2017-12-18 Online:2018-02-05 Published:2018-01-24
Contact: Xue-zhong YU E-mail:yxz@medmail.com.cn

摘要/Abstract

摘要： 目的比较模拟培训和传统培训方法在急诊住院医师中心静脉置管中的效果。方法在2016年5月1日至2017年5月1日期间，选取40名某教学医院急诊科轮转的住院医师。随机分为传统培训组和模拟培训组，分别进行中心静脉穿刺培训，培训后每人独立完成1例颈内静脉置管操作，并填写操作调查表。比较两组穿刺成功率、总操作时间、试穿刺次数和并发症发生率等。结果传统培训组有18名学员完成，模拟组共19名学员完成（完成表示独立完成1例操作并完整填写调查表）。完成学员中模拟组穿刺成功率73.7%，传统组穿刺成功率33.3%，模拟组穿刺成功率较传统组明显提高（P<0.05）；模拟组总操作时间（21.3±4）min，传统组（31.3±5.9）min；模拟组试穿次数（2.1±1）次，传统组（4.5±1）次；模拟组并发症发生率16%±37%，传统组38%±50%；模拟组与传统组相比，操作时间显著缩短（P<0.05），穿刺次数显著减少（P<0.05），并发症发生率显著降低（P<0.05）。结论模拟培训与传统培训相比提高了急诊住院医师颈内静脉置管成功率，缩短了操作时间，降低了并发症发生率，值得教学医院在住院医师培训中推广应用。

关键词: 模拟培训，中心静脉置管

Abstract: Objection To compared the effect between simulaion training and traditional training on central venous cathertrization(CVC). Methods Forty emergency residents came from a teaching hospital were selected during May 2016 to May 2017, and they were randomly assigned into two groups:simulation group（SG）and traditional group（TG）. After the training they must completed one CVC and filled in a questionaire. The success rate、puncture time、trail time and complication rate between the two groups were compared. Results There were 18 students on tradional group(TG) and 19 students on simulation group(SG) who completed the whole procedure(complete the procedure independently and filled in the questionaire). The success rate of SG and TG were 73.7% and 33.3% respectively(P<0.05).the lengthen of procedure was （21.3±4）min on SG and （31.3±5.9）min on TG, The trail times were （2.1±1 ）on SG and （4.5±1）on TG, the complication rate was 16%±37% on SG and 38%±50% on TG, compared with TG, the lengthen of procedure on SG was significantly shortened(p<0.05),the trail times on SG were significantly reduced(p<0.05) and the complication rate was significantly decreased(P<0.05). Conclusions Compared with traditional training , the simulation training significantly improved the success rate of CVC,shortened the lengthen of procedure ,decreased the trail times and complication rate. It deserved teaching hospitals to popularizeing on standardized training for resident physicians.

Key words: simulation training central venous cathertrization(CVC)

刘安雷刘聚源徐军刘继海朱华栋于学忠. 模拟培训在急诊中心静脉置管培训中的应用[J]. 基础医学与临床, 2018, 38(2): 269-271.