目的 探讨喉罩置入在外科住院医师规范化培训气道危机情境模拟教学中的应用效果。方法 2017年7月至2018年6月,将在皖南医学院弋矶山医院麻醉科进行外科住院医师规范化培训轮转的48名学员按照入科顺序分为试验组与对照组,每组24名学员。试验组实施情境模拟下的喉罩置入培训,对照组实施单纯的任务训练器喉罩置入培训。培训结束后,比较两组学员理论考试成绩和在模拟临床危机事件下急救气道处理能力,包括喉罩置入成功率等技术能力和解决问题能力等非技术能力;对两组学员开展培训满意度的问卷调查。结果 试验组与对照组学员理论成绩差异无统计学意义[(88.0±4.2)分比(86.0±3.4)分,P=0.076];与对照组学员相比,试验组学员喉罩置入成功率更高[75.0%(18/24)比45.8%(11/24),P=0.039)],解决问题能力评分更高[(6.4±0.5)分比(2.1±1.2)分,P<0.01],教学总体满意度更高[(4.1±0.5)分比(3.5±0.6)分,P<0.01],差异均具有统计学意义。结论 气道危机情境模拟喉罩置入培训的应用,可以有效提高外科住院医师规范化培训学员急救气道管理能力。

Objective To explore the application effect of the laryngeal mask in the simulation of the airway crisis situation in the standardized training of surgical residents. Methods July 2017 to June 2018, 48 patients in the anesthesiology department of our hospital were selected to be rotated and surgically trained, and divided into test group and control group of 24 people each. Test group: training for laryngeal mask placement in a simple task trainer; control group: training in laryngeal mask placement under crisis scenario scenarios. After the training, the two groups of students were compared with the theoretical achievement, and first-aid airway treatment ability under simulated clinical crisis events, including technical ability and non-technical ability. The questionnaires were sent to the participants for feedback. Results After the training, the theoretical scores ofthe test group and control group were not statistically different (88.0±4.2 vs 86.0±3.4, P=0.076). Compared with the control group, the test group had higher success rate of laryngeal mask placement [75.0%(18/24) vs 45.83%(11/24), P=0.039], higher score of problem-solving ability (6.4±0.5 vs 2.1±1.2, P<0.01) and higher overall satisfaction of teaching (4.1±0.5 vs 3.5±0.6, P<0.01). Conclusions The application of laryngeal mask in airway crisis situation simulation could effectively improve the emergency airway management ability of surgical resident standardized training students.