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[模拟对降低肩难产新生儿及产妇发病率的影响]

[Impact of simulation to reduce neonatal and maternal morbidity of shoulder dystocia].

作者信息

Legendre G, Bouet P-E, Sentilhes L

机构信息

Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris Sud, 94276 Le Kremlin-Bicêtre cedex, France.

Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2015 Dec;44(10):1285-93. doi: 10.1016/j.jgyn.2015.09.047. Epub 2015 Oct 31.

Abstract

OBJECTIVE

To assess the role of simulation in reducing morbidity and mortality of shoulder dystocia.

METHODS

A systematic literature review was conducted in the Medline database.

RESULTS

Regarding the prevention of complications of shoulder dystocia, practical training using mannequin is associated with improvements in management shoulder dystocia than training using video tutorial (EL2). Practical training using simulation for shoulder dystocia allows an improvement for manoeuvres mainly for trainees, but simulation seems to benefit to all caregivers for the communication (EL3). The effect of training sessions using simulation for learning writing the medical observation allows only a modest improvement in the medical record transcription (EL3). The interest of a specific grid for reporting shoulder dystocia seems interesting to increase the amount of information transcribed by the caregiver (EL3). The establishment of a practical training using simulation and concerning all caregivers of the delivery room is associated with a significant reduction in neonatal injury (EL3). The establishment of a training program using simulation does not seem to decrease maternal morbidity in case of shoulder dystocia (EL3).

CONCLUSION

A teaching using simulation for the management of shoulder dystocia is encouraged for the initial and continuing formation of different actors in the delivery room (professional agreement).

摘要

目的

评估模拟训练在降低肩难产发病率和死亡率方面的作用。

方法

在Medline数据库中进行了系统的文献综述。

结果

关于预防肩难产并发症,使用人体模型进行实践培训比使用视频教程进行培训在处理肩难产方面有更好的效果(证据水平2)。使用模拟训练处理肩难产主要能使学员在操作上有所改进,但模拟训练似乎对所有医护人员在沟通方面都有益处(证据水平3)。使用模拟训练课程学习书写医疗观察记录仅能在病历转录方面有适度改进(证据水平3)。使用特定表格报告肩难产似乎有助于增加医护人员记录的信息量(证据水平3)。建立针对产房所有医护人员的模拟实践培训与新生儿损伤显著减少相关(证据水平3)。建立模拟训练项目似乎并未降低肩难产情况下的产妇发病率(证据水平3)。

结论

鼓励在产房对不同人员进行初始和持续培训时采用模拟训练来处理肩难产(专业共识)。

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