国际麻醉学与复苏杂志   2022, Issue (9): 0-0
    
床旁气道超声技术培训的实践与效果分析
肖静, 李琴琴, 李世勇, 周志强, 姚文龙, 罗爱林1()
1.华中科技大学同济医学院附属同济医院麻醉科
Practice and effect analysis of the training course for determining the position of tracheal intubation by point‑of‑care ultrasound of the upper airway
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摘要:

【摘要】 目的 分析床旁气道超声技术培训在临床麻醉医师中的实践效果,为临床普及床旁气道超声提供有效的培训方案。 方法 选择无床旁气道超声技术的麻醉医师为培训对象,根据教学目标设计床旁气道超声培训课程,采用理论+实践等多种教学方式相结合的方法实施培训,培训后考核学员对气管插管超声图像(插管后静态超声图、气管插管动态视频)的识别能力及床旁气道超声检测的操作能力。 结果 参加培训的学员共52名。培训后学员识别插管后静态超声图的敏感度为82.7%(95%CI 72.1%~93.3%),特异性为90.4%(95%CI 82.1%~98.7%),准确性为86.5%(95%CI 79.9%~93.2%);学员识别气管插管动态视频的敏感度为92.3%(95%CI 84.8%~99.8%),特异性为92.3%(95%CI 84.8%~99.8%),准确性为92.3%(95%CI 84.8%~99.8%)。学员床旁气道超声检测操作能力考核100%合格。培训后100%的学员对培训表示满意,98.08%的学员有信心将床旁气道超声技术用于气管插管位置的判断。 结论 床旁气道超声技术培训能帮助麻醉医师快速、准确地掌握气道超声技术,并将其应用于气管插管位置的判断。

关键词: 技术培训; 课程设置; 床旁气道超声; 气管插管
Abstract:

【Abstract】 Objective To explore the teaching practice and effect of a training course of point‑of‑care ultrasound of the upper airway in clinical anesthesiologists, so as to provide an effective training program for clinical popularization of this technique. Methods Anesthesiologists without clinical experience in point‑of‑car airway ultrasound were selected as the training subjects. The point‑of‑care airway ultrasound training course was designed according to the teaching objectives, and carried out through theoretical and practical training. After training, the trainees were evaluated for their ability to recognize ultrasonic images after endotracheal intubation and practical ability to perform point‑of‑care ultrasound in the airway. Results A total of 52 trainees participated in the training. After training, the trainees showed a sensitivity of 82.7% [95% confidence interval (CI) 72.1%, 93.3%], a specificity of 90.4% (95%CI 82.1%, 98.7%), and an accuracy of 86.5% (95%CI 79.9%, 93.2%) in identifying static ultrasound images after tracheal intubation. The trainees showed a sensitivity of 92.3% (95%CI 84.8%, 99.8%), a specificity of 92.3% (95%CI 84.8%, 99.8%), and an accuracy of 92.3% (95%CI 84.8%, 99.8%) in identifying dynamic ultrasound images after tracheal intubation. The point‑of‑care airway ultrasound was 100% qualified. Furthermore, 100% of the trainees were satisfied with the training and 98.08% were confident to apply point‑of‑care airway ultrasound in determining the position of the tracheal tube. Conclusions The point‑of‑care airway ultrasound can assist anesthesiologists to quickly and accurately master the skills of airway ultrasound for determining the position of endotracheal intubation.

Key words: Technical training; Curriculum offering; Point‑of‑care airway ultrasound; Tracheal intubation