麻醉科规范化培训住院医师接受快速肺超声培训后诊断围术期气胸的可行性与可靠性研究

发布时间：2018-11-13 14:36

【摘要】：目的:探讨麻醉科规范化培训住院医师接受快速肺超声培训后诊断围术期气胸的可行性与可靠性。方法:麻醉科规范化培训住院医师接受2小时快速肺超声培训后,采用两步法以床旁肺超声诊断围术期气胸。以胸部CT检查为金标准,计算超声扫查气胸的敏感度、特异度、阳性预测值、阴性预测值及X线胸片相应指标。结果:共计纳入73名患者,麻醉科规范化培训住院医师接受2小时快速肺超声培训后,采用两步法以床旁肺超声诊断围术期气胸的敏感度、特异度、阳性预测值、阴性预测值分别为:88.1%,100%,100%,96.1%。超声扫查耗时5±1分钟;X线胸片耗时22±2.6分钟,显著长于超声诊断耗时(P0.001)。学员均完成课程,独立完成20±1例患者肺超声扫查后,其学习曲线达平台期。结论:麻醉科规范化培训住院医师接受2小时快速肺超声培训后,采用两步法以床旁肺超声诊断围术期气胸准确度高,以肺部超声影像学技术诊断气胸之方法可靠,易学,易掌握,适宜在麻醉科开展。
[Abstract]:Objective: to investigate the feasibility and reliability of standardized training in anesthesiology for the diagnosis of perioperative pneumothorax after rapid lung ultrasound training. Methods: two-step lung ultrasound was used to diagnose perioperative pneumothorax. The sensitivity, specificity, positive predictive value, negative predictive value and X-ray chest radiographic parameters of pneumothorax were calculated by using chest CT as the gold standard. Results: a total of 73 patients were included. After two hours of rapid lung ultrasound training, the sensitivity, specificity and positive predictive value of lung ultrasound were detected by bedside ultrasound in patients with pneumothorax during perioperative period. The negative predictive values were 88.1and 100 and 96.1, respectively. It took 5 卤1 minutes for ultrasonography and 22 卤2.6 minutes for chest radiography, which was significantly longer than that for ultrasonic diagnosis (P0.001). All the students completed the course and completed 20 卤1 cases of pulmonary ultrasound scan independently, and the learning curve reached the plateau stage. Conclusion: after 2 hours of rapid lung ultrasound training, the accuracy of diagnosis of pneumothorax in perioperative period by bedside ultrasound is high, and the diagnostic method of pneumothorax with pulmonary ultrasound imaging technique is reliable and easy to learn. Easy to master, suitable for development in anesthesiology.
【作者单位】：重庆市中医院麻醉科;四川大学华西医院麻醉科;
【分类号】：R614

【相似文献】