手术分级管理在冠脉介入培训及教学中应用探讨.docVIP

手术分级管理在冠脉介入培训及教学中应用探讨 　　[摘要] 目的 探讨冠脉介入诊疗技术分级管理在冠脉介入培训中的作用。 方法 回顾性总结我科实行手术分级管理前后两组接受培训医师的基本资料、培训结果，进行比较分析。 结果 实行手术分级管理后接受培训医师在理论知识水平、介入技能考核水平方面明显高于实施手术分级前的医师（P0.05）；并发症发生率明显低于后者（P0.05）；国家考试的通过率也略高于后者。 结论 手术分级管理制度对冠脉介入培训有很好的促进作用，效果显著，一方面提高了培训医师的知识水平和介入操作技能；另一方面降低了并发症发生率，保证了医疗安全。 　　[关键词] 冠状动脉介入治疗；冠状动脉造影；冠心病；培训；教学；分级 　　[中图分类号] R654 [文献标识码] C [文章编号] 1673-9701（2017）06-0133-04 　　[Abstract] Objective To explore the role of classification management of coronary interventional therapy in coronary intervention training. Methods The basic data and training results between the two groups before and after surgical classification management in our department were retrospectively summarized and comparatively analyzed. Results After surgical classification management， the levels of theoretical knowledge and skill assessment in the physician who received the training were significantly higher than those of the physician before surgery classification（P0.05）. The incidence of complications in the former was significantly lower than that of the latter（P0.05）. And the national examination pass rate in the former was also slightly higher than that of the latter. Conclusion Surgical classification management system has a good effect on coronary intervention training， and the effect is remarkable. On the one hand， it improves the knowledge level and intervention skills of the training physician. On the other hand， it reduces the complication rate and ensures the medical safety. 　　[Key words] Coronary intervention therapy； Coronary angiography； Coronary heart disease； Training； Teaching； Classification 　　在我??，冠状动脉介入治疗已处于快速发展时期，与此同时，国家卫计委颁布了《心血管疾病介入诊疗技术管理规范》[1]，成立了冠脉介入培训基地，旨在整体规范、提高我国的心血管介入治疗操作人员和单位的技术水平[2]。近年来，各基地的培训工作也如火如荼地开展起来，为国家培养了大批冠脉介入医师。但在培训中也暴露了一些问题，如培养方案相对固定：目标要求固定，培养过程固定，而这些学员具有不同的起点，不同的学习能力和学习进程，固定的培养模式无法实现个体化的培养，对于起点高的学员无法培养出更高水平的技术人才，而也有一些起点低的学员培训较为仓促，影响培养质量；另外，最终考核基本是理论考核，不能反映学员的实际水平。因此在卫计委《心血管疾病介入诊疗技术管理规范》和培训大纲的指导下，探索个体化的培训方案非常必要，有利于保证学员在较短的时间内掌握心血管介入技术[3]，更好地为人民健康服务。在培