气道解剖教学在急诊困难气道处理培训中的应用  

The application of anatomy in the resident training of the management of difficult airway among the patients undergoing emergent operations

作　　者：夏迪 马璐璐[1] 谭刚[1] 黄宇光[1] Xia Di;Ma Lu-lu;Tan Gang;Huang Yu-guang(Department of Anesthesiology,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]北京协和医院麻醉科,北京100730

出　　处：《中国急救医学》2022年第7期567-570,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨将气道解剖学引入急诊困难气道处理培训中的应用效果。方法选取2019年9月至2022年3月在北京协和医院麻醉科进行住院医师规范化培训的36名学员为研究对象,以急诊困难气道处理流程为主线,将解剖学基础与临床病例有机结合在一起进行讲解,并在授课前后通过自制试卷评估教学效果,并收集学员对课程的反馈意见。结果培训后,学员对于困难气道基础知识、困难气道评估和困难气道处理流程的认知均有所提高(P<0.05)。按年级和学历对客观评估结果进行分层分析显示,培训前,三年级组气道解剖基础知识(72.8±10.5 vs.62.8±9.7,P=0.005)和困难气道评估(75.7±5.5 vs.67.2±4.1,P<0.001)得分高于二年级组;培训后,三年级组困难气道评估(95.7±2.7 vs.91.4±4.7,P=0.005)和困难气道处理原则及流程(95.8±3.5 vs.90.4±5.1,P=0.001)得分高于二年级组。培训前,研究生及以上组住院医师在气道解剖基础知识(71.8±11.4 vs.62.8±8.9,P=0.015)和困难气道处理原则及流程得分(75.0±6.0 vs.68.8±7.6,P=0.009)高于本科组;而培训后,研究生及以上组和本科组各项目客观评价得分差异无统计学意义。年级和学历对客观评估的结果影响不一,提示应根据不同年级和不同学历采取不同的授课方式及授课内容,以提高教学效果。结论将气道解剖学引入急诊困难气道处理培训中的教学方式得到了学员的认可,有助于提高学员对困难气道流程的理解,提高其临床技能。Objective To investigate the role of airway anatomy in the resident training of the management of difficult airway in emergent operations.Methods Thirty-six residents who had their training at the department of anesthesiology,Peking Union Medical College Hospital,participated in our training course.The course focused on the combination of anatomy and clinical management.Objective and subjective evaluation were performed before and after training course.Results After the training,the trainees′cognition of the basic knowledge of difficult airway,difficult airway assessment and difficult airway management process were improved(P<0.05).A stratified analysis of objective assessment results classified by grade and educational background showed that basic knowledge of airway anatomy(72.8±10.5 vs.62.8±9.7,P=0.005)and difficult airway assessment(75.7±5.5 vs.67.2±4.1,P<0.001)in the 3rd grade group were higher than those in the 2nd grade group before training.After the training,difficult airway assessment(95.7±2.7 vs.91.4±4.7,P=0.005)and difficult airway management principles and procedures(95.8±3.5 vs.90.4±5.1,P=0.001)in the 3rd grade group were higher than those in the 2nd grade group.Before the training,basic knowledge of airway anatomy(71.8±11.4 vs.62.8±8.9,P=0.015)and difficult airway management principles and procedures(75.0±6.0 vs.68.8±7.6,P=0.009)of the resident physicians in the postgraduate and above groups were higher than those in the undergraduate education group.After training,there was no significant difference in the objective evaluation scores of each item between the postgraduate and above groups and the undergraduate group.Grades and educational backgrounds had different effects on the results of objective evaluation,which suggested that we should adopt different teaching methods and teaching contents according to different grades and different educational backgrounds to improve teaching effects.Conclusions The application of anatomy in the training of difficult airway management among the p

关 键 词：困难气道 解剖 教学 住院医师 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]