山羊创伤模型在培训基层军医战场关键急救技术的价值  

Value of goat models in improving key first aid skills of combat medics

作　　者：郑新华 袁跃彬[2] 刘国栋[3] 

机构地区：[1]平顶山学院医学院基础医学系,河南省平顶山市467000 [2]解放军第一五二医院门诊部 [3]陆军军医大学大坪医院野战外科研究所八室

出　　处：《中华创伤杂志》2018年第1期57-60,共4页Chinese Journal of Trauma

基　　金：济南军区后勤科研计划（CJN10L058）

摘　　要：目的评价山羊创伤模型培训对提高基层军医战场关键急救技术的价值。方法选择45只健康成年山羊采用氯胺酮麻醉。填塞山羊口腔和鼻腔制作山羊窒息模型，刺破山羊胸腔制作气胸模型，剪开山羊肢体大动脉制作大出血模型，培训83名基层军医气管切开、胸腔闭式引流和大动脉缝合三项技术。比较培训前、培训后（培训刚结束时）和培训1年后基层军医完成上述三项技术水平的差异；比较培训前后基层军医军龄、文化程度对考核成绩的影响；调查基层军医对山羊创伤模型的认可度。结果83名基层军医培训前独立完成气管切开、胸腔闭式引流、大动脉缝合三项技术成功率分别为39％、33％、25％；培训后分别为94％、86％、64％；培训结束1年后分别为74％、62％、43％。与培训前相比，培训后三项技术水平均明显提高（P均〈0．01）；与培训后相比，培训结束1年后三项技术水平下降明显（P均〈0．01）。军龄对培训前手术成功率有影响（P〈0．05），对培训后成绩无影响（P〉0．05）。文化程度对培训前（P〈0．01）和培训后（P〈0．05）手术成功率均有显著性影响。横断面调查结果显示，面对多种教学方式，80％的基层军医首选动物模型教学方式。结论山羊创伤模型制作简便，利用此模型，基层军医易掌握创伤急救关键技术，值得推广。Objective To evaluate the value of goat models in training and promoting key first aid skills of combat medics. Methods A total of 45 goats were anaesthetized with ketamine. Asphyxia models were created by wadding the goats＇ mouths and noses, pneumothorax models were established by piercing goats＇ chests, and massive hemorrhage models were built by piercing goats＇ limbs. Based on the above models, 83 combat medics were trained to perform tracheotomy, tube thoracostomy, and artery suture. The differences in mastering these three skills before training, after training （immediately after training） , and one year after training were recorded and compared. The effect of military service length and education background on the skill examination was evaluated before and after training. The recognition of the goat models from the combat medics was investigated. Results Before the training, success rates of performing tracheotomy, tube thoracostomy and artery suture were 39% , 33% and 25% , respectively. After the training, the corresponding parameters were 94% , 86% and 64% , respectively. One year after training, the success rates dropped to 66% , 62% and 43% , respectively. Compared with the status before training, the improvement of three skills was statistically significant after training （ P 〈 0.01 ）. The decrease of three skills one year after training was statistically significant （ P 〈 0.01 ）. The military service length had effects on the performance before training （ P 〈 0.05 ）. And the military service length had no effect on the performance after the training （ P 〉 0.05 ）. Education background had effects on the performance of surgical success rates before （ P 〈 0.01 ） and after training （ P 〈 0.05 ）. According to the cross-sectional study, 80% of the military doctors cbose the goat models as the first option for training. Conclusion Goat models are not only easy to be created but also are suitable for training the combat medics in key first aid skills. Such model

关 键 词：模型 动物 气管切开术 胸廓造口术 吻合术 外科 军队医生 

分 类 号：R82[医药卫生—临床医学]