【摘要】 目的探讨对于没有心脏超声基础的麻醉医师预先进行经胸心脏超声(TTE)培训是否能够提高经食道心脏超声(TEE)模拟教学的效果。方法将84名没有心脏超声基础的麻醉专业医师随机分为两组:TTE+TEE组(TTE培训之后再进行TEE模拟器授课并练习)(n=41)和TEE组(直接进行TEE模拟器授课并练习)(n=43)。授课前和培训后均进行涵盖5个心脏超声相关知识点的笔试。1个月后对两组再次进行笔试考核。结果两组授课前笔试分数没有显著差别。TTE+TEE组解剖结构识别题目的分数显著高于TEE组(71.5%±18.3%vs 48.8%±18.3%,P<0.01)。临床应用题目的分数则显著低于TEE组(38.4%±8.7%vs 45.2%±14.2%,P<0.01),患者安全、探头操作、病理视频的分数没有显著差异。培训后4周的笔试中,TTE+TEE组麻醉医生切面识别(54.3%±21.8%vs 43.3%±21.2%,P<0.05)和解剖结构识别(43.3%±22.0%vs 34.0%±22.7%,P<0.05)的题目分数均较高。结论麻醉医师在TEE培训之前预先接受TTE培训,在短时间内能够更准确的识别TEE图像的解剖结构,且对切面和解剖结构的记忆更为深刻。更多还原

【Abstract】 Objective To assess the impact of transthoracic echocardiography( TTE) skills training in Transesophageal endocardiography( TEE) trainees. Methods In this prospective randomized study,84 anesthesiologists( novice in echocardiography) were randomized into either TTE + TEE group( n = 41) or TEE group( n = 43). A standardized pretest was administered before the training. The trainees in TTE + TEE group firstly learned TTE skills followed by simulation-based TEE training. And the trainees in TEE group only had simulation-based TEE training session. Comprehension in both groups was then assessed with a written posttest immediately after training and 4weeks later. Results Pretest scores revealed similar knowledge among the trainees. The TTE group score is higher on echocardiography anatomy after the training session( 71. 5% ± 18. 3% vs 48. 8% ± 18. 3%,P < 0. 01; TTE +TEE group versus TEE group,respectively),but the score is lower in clinical applications( 38. 4% ± 8. 7%vs 45. 2% ± 14. 2%,P < 0. 01). The two groups showed no difference in patient safety,probe manipulation andpathology scores. In a 4-week later test,TTE + TEE group scored higher on both view identification and structure identification questions. Conclusions After TTE training,the trainees may know better in echocardiography anatomy,and the memory of TEE views and structures lasted longer.更多还原