超声引导颈内静脉穿刺置管学习曲线的构建与分析  

The construction and analysis of learning curve for ultrasound-guided internal jugular vein catheterization

作　　者：张海龙[1] 李旭[1] 吴迪[1] 赵丽琴 Hai-Long ZHANG;Xu LI;Di WU;Li-Qin ZHAO(Department of Anesthesia,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Department of Anesthesia,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京潞河医院麻醉科,北京101149 [2]首都医科大学附属北京地坛医院麻醉科,北京100015

出　　处：《数理医药学杂志》2023年第12期955-960,共6页Journal of Mathematical Medicine

摘　　要：目的构建麻醉科住院医师超声引导颈内静脉穿刺置管的学习曲线,为超声引导颈内静脉穿刺置管的规范化培训和资格准入提供参考与依据。方法选取10名在首都医科大学附属北京潞河医院麻醉科进行第一年规范化培训、且无颈内静脉穿刺置管操作经验的住院医师为研究对象,前期培训结束后,每名医师按照时间顺序完成25例超声引导右颈内静脉穿刺置管操作。记录每位学员的颈内静脉穿刺置管情况,利用累积和(cumulative sum,CUSUM)分析法构建学习曲线,并计算掌握该项穿刺置管技术所需的最少例数。结果学习曲线函数为y=0.0022x^(3)-0.1201x^(2)+2.0403x-0.9464,决定系数R^(2)=0.9787,当曲线斜率为零时,对应的x值为13.51。结论学习曲线分析显示,麻醉科住院医师最少需要完成14次操作可掌握超声引导颈内静脉穿刺置管技术,作为一项学习曲线较短的实用性技能,值得在麻醉科住院医师规范化培训中开展。Objective To construct the learning curve of ultrasound-guided internal jugular venocentesis catheterization for anesthesiology residents,so as to provide reference and basis for standardized training and qualification admission of ultrasound-guided internal jugular venocentesis catheterization.Methods 10 first-year resident physicians without experience in internal jugular venocentesis catheterization who received standardized training in Department of Anesthesiology,Beijing Luhe Hospital,Capital Medical University were selected as the research subjects.After the previous training,each physician completed 25 cases of right internal jugular vein puncture using ultrasound guided in chronological order.The internal jugular vein puncture of each trainee was recorded,the learning curve was established by cumulative sum(CUSUM)method,and the minimum number of cases required to master the corresponding catheterization technique was calculated.Results The learning curve function is y=0.0022x^(3)-0.1201x^(2)+2.0403x-0.9464,with the determination coefficient R^(2)=0.9787.When the slope of the curve is zero,the corresponding x value is 13.51.Conclusion Learning curve analysis showed that anesthesiology residents needed to complete at least 14 puncture operations to master ultrasound-guided internal jugular vein catheterization.As a practical skill with a short learning curve,it is worth conducting in the standardized residency training programs of anesthesiology residents.

关 键 词：导管插入术 中心静脉 超声检查 麻醉科住院医师 学习曲线 累计和分析法 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]