摘要
目的探讨超声引导下经皮肝穿活检术规范化培训流程并建立培训体系。方法针对厦门中医院肝病中心47名医护人员制定经皮肝穿活检术详细培训课程,包括理论授课,超声引导下离体牛肝脏穿刺实践培训,理论和实践考试3部分内容。理论考试(肝穿理论知识考试和超声图像识别考试)与实践考试均为90分以上为合格(每项满分100分),90分以下为不合格。考试合格者再进行6个月临床实践操作,如果活检组织条合格,未出现需要处理的并发症,可以从事活体肝脏穿刺,如果组织条不合格或出现需要处理的并发症为不合格者,不能从事活体肝脏穿刺,全部课程重新培训,考试及实践。结果 47名培训者理论考核分平均为(90.5±1.35)分,超声图像识别平均(95.0±1.50)分,实践考试平均分为(97.87±0.62)分。实践培训第一轮垂直标本穿刺平均命中率22.93%,第二轮垂直标本穿刺平均命中率80.60%;实践培训第一轮非垂直标本穿刺平均命中率16.20%,第二轮非垂直标本穿刺平均命中率86.54%;实践考核命中率97.87%。第一轮垂直标本穿刺平均命中率22.93%,第二轮垂直标本穿刺平均命中率80.59%;第二轮垂直标本穿刺平均命中率与第一轮对比,差异有统计学意义(P<0.01),实践培训第一轮非垂直标本穿刺平均命中率16.20%,第二轮非垂直标本穿刺平均命中率86.54%;第二轮非垂直标本穿刺平均命中率与第一轮比较,差异有统计学意义(P<0.01)。结论建立超声引导下经皮肝穿活检术规范化培训体系非常必要。
Objective To investigate the standardized trainiOg process of ultrasound guided percutaneous liver biopsy and establish a training system. Methods The detailed training course of percutaneous liver biopsy was carried out for 47 doctors and nurses in the liver disease center of Xiamen Traditional Chinese Medical Hospital, it including theoretical teaching, ultrasound guided liver biopsy practice training, theoretical and practical examination of 3 parts. The theoretical examination （liver wear theory test and ultrasonic image recognition test） and practice examination were above 90 points （100 points per mark）, and 90 points below were unqualified. 6 months of clinical practice should be carried out for those who have passed the examination, if the biopsy tissue is qualified and no complications are required, the living liver biopsy can be performed, If the tissue was unqualified or the complication that needs to be treated was unqualified, it couldn＇t engaged in living liver biopsy, all courses re training, examination and practice. Results The theoretical scores of the 47 trainers averaged （90.5±1.35） points, ultrasonic image recognition averaged （95.0±1.50） points, practice exam averages （97.87±0.62）points. average hit rate of the first round vertical specimen puncture was 22.93%, average hit rate of second round vertical specimen puncture was 80.60%; In practice, the average hit rate of the first round of non vertical specimens was 16.20%, average hit rate of second rounds of non vertical specimens was 86.54%; hit rate of practice examination was 97.87%, average hit rate of the first round vertical specimen puncture was 22.93%, average hit rate of second round vertical specimen puncture was 80.59%; average hit rate of the second round vertical specimen puncture compared with the first round, the difference was statistically significant （P 〈 0.01）. In practice, the average hit rate of the first round of non vertical specimens was 16.20%, average hit rate of second rounds of non vertical specimens was 86.54%; Compared with the first round, the average hit rate of the second rounds of non vertical specimens was statistically significant （P 〈 0.01）. Conclusion It is necessary to establish standardized training system for percutaneous liver biopsy guided by ultrasound.
出处
《中国继续医学教育》
2017年第22期3-5,共3页
China Continuing Medical Education
基金
厦门中医院院内资助课题(2015001)
关键词
超声引导
经皮肝穿活检术
规范化培训
ultrasound guided
percutaneous liver biopsy
standardized training
