Clinical Focus ›› 2024, Vol. 39 ›› Issue (11): 993-999.doi: 10.3969/j.issn.1004-583X.2024.11.006
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Zeng Xueying1, Yin Wanhong1(), Qin Yao1, Wang Yiping2, Cao Lianghai3, Lei Xianying4, Liao Xuelian1,5
Received:
2024-08-30
Online:
2024-11-20
Published:
2024-12-04
Contact:
Yin Wanhong
E-mail:yinwanhong@wchscu.cn
CLC Number:
Zeng Xueying, Yin Wanhong, Qin Yao, Wang Yiping, Cao Lianghai, Lei Xianying, Liao Xuelian. Survey of the application and demands of critical care ultrasound in critical illnesses in tertiary hospitals of Sichuan Province[J]. Clinical Focus, 2024, 39(11): 993-999.
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.11.006
累计进行重症超声 评估情况(例次) | 医生 | 护士 | |||
---|---|---|---|---|---|
人数 | 占比(%) | 人数 | 占比(%) | ||
从未使用 | 76 | 14.73 | 247 | 58.95 | |
50以下 | 181 | 35.08 | 126 | 30.07 | |
50~200 | 148 | 28.68 | 32 | 7.64 | |
200~500 | 68 | 13.18 | 9 | 2.15 | |
500以上 | 43 | 8.33 | 5 | 1.19 |
Tab.1 Application number of critical care ultrasound in medical staff
累计进行重症超声 评估情况(例次) | 医生 | 护士 | |||
---|---|---|---|---|---|
人数 | 占比(%) | 人数 | 占比(%) | ||
从未使用 | 76 | 14.73 | 247 | 58.95 | |
50以下 | 181 | 35.08 | 126 | 30.07 | |
50~200 | 148 | 28.68 | 32 | 7.64 | |
200~500 | 68 | 13.18 | 9 | 2.15 | |
500以上 | 43 | 8.33 | 5 | 1.19 |
超声机配置情况 | 三甲 | 三乙 | |
---|---|---|---|
超声机台数(台) | 0 | 9(9.89) | 28(37.33) |
1 | 63(69.23) | 44(58.67) | |
2 | 14(15.38) | 3(4.00) | |
3 | 4(4.40) | / | |
4 | 1(1.10) | / | |
配置超声机类型 | 掌上超声 | 3 | 1 |
便携超声/笔记本 | 27 | 22 | |
台式超声 | 56 | 30 | |
其他 | 9 | 24 |
Tab.2 Configuration of critical care ultrasound in critical care departments of 166 hospitals (number of hospitals [n, %])
超声机配置情况 | 三甲 | 三乙 | |
---|---|---|---|
超声机台数(台) | 0 | 9(9.89) | 28(37.33) |
1 | 63(69.23) | 44(58.67) | |
2 | 14(15.38) | 3(4.00) | |
3 | 4(4.40) | / | |
4 | 1(1.10) | / | |
配置超声机类型 | 掌上超声 | 3 | 1 |
便携超声/笔记本 | 27 | 22 | |
台式超声 | 56 | 30 | |
其他 | 9 | 24 |
疾病群体分类 | 进行重症超声评估的比例 | ||||
---|---|---|---|---|---|
无 | 20%以下 | 20%~50% | 50%~80% | 80%~100% | |
休克 | 6.19% | 19.03% | 17.92% | 22.79% | 34.07% |
ARDS | 7.74% | 21.68% | 19.69% | 26.55% | 24.34% |
TBI | 19.25% | 27.21% | 21.46% | 17.70% | 14.38% |
脑卒中 | 25.00% | 34.51% | 19.69% | 13.50% | 7.30% |
脓毒症 | 6.64% | 15.49% | 14.16% | 26.33% | 37.39% |
胰腺炎 | 14.82% | 18.36% | 14.16% | 24.34% | 28.32% |
CPR术后 | 11.50% | 18.81% | 15.49% | 21.68% | 32.52% |
急性呼吸循环障碍(1 h内) | 10.62% | 30.53% | 23.67% | 17.26% | 17.92% |
Tab.3 Use of critical care ultrasound in assessing critical illnesses of physicians
疾病群体分类 | 进行重症超声评估的比例 | ||||
---|---|---|---|---|---|
无 | 20%以下 | 20%~50% | 50%~80% | 80%~100% | |
休克 | 6.19% | 19.03% | 17.92% | 22.79% | 34.07% |
ARDS | 7.74% | 21.68% | 19.69% | 26.55% | 24.34% |
TBI | 19.25% | 27.21% | 21.46% | 17.70% | 14.38% |
脑卒中 | 25.00% | 34.51% | 19.69% | 13.50% | 7.30% |
脓毒症 | 6.64% | 15.49% | 14.16% | 26.33% | 37.39% |
胰腺炎 | 14.82% | 18.36% | 14.16% | 24.34% | 28.32% |
CPR术后 | 11.50% | 18.81% | 15.49% | 21.68% | 32.52% |
急性呼吸循环障碍(1 h内) | 10.62% | 30.53% | 23.67% | 17.26% | 17.92% |
项目 | 应用重症超声比例 | ||||
---|---|---|---|---|---|
无 | 20%以下 | 20%~50% | 50%~80% | 80%~100% | |
深静脉穿刺 | 4.87% | 17.04% | 20.13% | 26.55% | 31.42% |
胸腹腔穿刺 | 5.09% | 11.73% | 9.73% | 15.27% | 58.19% |
心包穿刺 | 33.19% | 17.48% | 6.86% | 6.86% | 35.62% |
ECMO置管/引导 | 51.55% | 12.17% | 4.20% | 5.09% | 26.11% |
IABP置管/引导 | 52.88% | 13.72% | 6.86% | 7.52% | 18.36% |
Tab.4 Application of critical care ultrasound in invasive diagnosis and treatment of critical illnesses by physicians
项目 | 应用重症超声比例 | ||||
---|---|---|---|---|---|
无 | 20%以下 | 20%~50% | 50%~80% | 80%~100% | |
深静脉穿刺 | 4.87% | 17.04% | 20.13% | 26.55% | 31.42% |
胸腹腔穿刺 | 5.09% | 11.73% | 9.73% | 15.27% | 58.19% |
心包穿刺 | 33.19% | 17.48% | 6.86% | 6.86% | 35.62% |
ECMO置管/引导 | 51.55% | 12.17% | 4.20% | 5.09% | 26.11% |
IABP置管/引导 | 52.88% | 13.72% | 6.86% | 7.52% | 18.36% |
项目 | 医生 | 护士 | |||||
---|---|---|---|---|---|---|---|
无 | 0~50% | 50%~100% | 无 | 0~50% | 50%~100% | ||
采用重症超声评估 | 18.14% | 40.27% | 41.59% | 9.23% | 39.49% | 51.28% | |
使用后改变决策 | 17.92% | 43.14% | 38.94% | 10.26% | 30.77% | 58.97% | |
使用后提高成功率 | 17.26% | 38.27% | 44.47% | 9.74% | 27.18% | 63.08% | |
重症超声未提供有效信息 | 27.21% | 60.18% | 12.61% | 21.03% | 43.59% | 35.38% | |
导致误判 | 29.42% | 63.94% | 6.64% | 24.62% | 45.64% | 29.74% |
Tab.5 Evaluation of peripheral arteriovenous puncture by medical staff using critical care ultrasound in critical illnesses within the past 3 years
项目 | 医生 | 护士 | |||||
---|---|---|---|---|---|---|---|
无 | 0~50% | 50%~100% | 无 | 0~50% | 50%~100% | ||
采用重症超声评估 | 18.14% | 40.27% | 41.59% | 9.23% | 39.49% | 51.28% | |
使用后改变决策 | 17.92% | 43.14% | 38.94% | 10.26% | 30.77% | 58.97% | |
使用后提高成功率 | 17.26% | 38.27% | 44.47% | 9.74% | 27.18% | 63.08% | |
重症超声未提供有效信息 | 27.21% | 60.18% | 12.61% | 21.03% | 43.59% | 35.38% | |
导致误判 | 29.42% | 63.94% | 6.64% | 24.62% | 45.64% | 29.74% |
Fig.2 The proportion of critical syndrome with 50% use of critical care ultrasound in critical ill patients and the change rate of diagnosis and treatment decision
比例/准确率 | 完整方案化检查 (比例) | 评估脏器异常情况 (准确率) | 解读病理生理异常及 机体反应失调(准确率) | 获取达质控标准图像 (标准率) | 标准率 |
---|---|---|---|---|---|
0~20% | 63.05% | 24.56% | 31.64% | 27.21% | 10%以下 |
20%~50% | 22.35% | 47.79% | 46.68% | 41.59% | 10%~50% |
50%~80% | 11.06% | 22.57% | 18.58% | 18.81% | 50%以上 |
80%以上 | 3.54% | 5.09% | 3.10% | 12.39% | 不清楚标准 |
Tab.6 Mastery of critical care ultrasound in physicians
比例/准确率 | 完整方案化检查 (比例) | 评估脏器异常情况 (准确率) | 解读病理生理异常及 机体反应失调(准确率) | 获取达质控标准图像 (标准率) | 标准率 |
---|---|---|---|---|---|
0~20% | 63.05% | 24.56% | 31.64% | 27.21% | 10%以下 |
20%~50% | 22.35% | 47.79% | 46.68% | 41.59% | 10%~50% |
50%~80% | 11.06% | 22.57% | 18.58% | 18.81% | 50%以上 |
80%以上 | 3.54% | 5.09% | 3.10% | 12.39% | 不清楚标准 |
重症超声应用过程中存在的困难 | 计数 | 百分比 |
---|---|---|
有资质人员不足 | 740 | 79.14% |
培训课程覆盖不够 | 584 | 62.46% |
重症超声设备不足 | 581 | 62.14% |
重症超声图像判读困难 | 538 | 57.54% |
重症超声信息解读困难 | 497 | 53.16% |
可视化信息太丰富应用困难 | 341 | 36.47% |
检查目的不清晰 | 228 | 24.39% |
其他 | 48 | 5.13% |
Tab.7 Difficulties in the application of critical care ultrasound
重症超声应用过程中存在的困难 | 计数 | 百分比 |
---|---|---|
有资质人员不足 | 740 | 79.14% |
培训课程覆盖不够 | 584 | 62.46% |
重症超声设备不足 | 581 | 62.14% |
重症超声图像判读困难 | 538 | 57.54% |
重症超声信息解读困难 | 497 | 53.16% |
可视化信息太丰富应用困难 | 341 | 36.47% |
检查目的不清晰 | 228 | 24.39% |
其他 | 48 | 5.13% |
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