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放射科实习医生与放射科教员在影像引导操作中的透视时间:一项对5.5年期间17966份报告的回顾性研究。

Radiology Trainee vs Faculty Radiologist Fluoroscopy Time for Imaging-Guided Procedures: A Retrospective Study of 17,966 Reports Over a 5.5-Year Period.

作者信息

DeSimone Ariadne K, Post Andrew, Duszak Richard, Duong Phuong-Anh T

机构信息

Department of Medicine, Emory University School of Medicine, Atlanta, GA.

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA.

出版信息

Curr Probl Diagn Radiol. 2018 Jul-Aug;47(4):233-237. doi: 10.1067/j.cpradiol.2017.07.003. Epub 2017 Jul 8.

Abstract

To evaluate differences in fluoroscopy time (FT) for common vascular access and gastrointestinal procedures performed by radiology trainees vs faculty radiologists. Report information was extracted for all 17,966 index fluoroscopy services performed by trainees or faculty, or both from 2 university hospitals over 66 months. Various vascular access procedures (eg, peripherally inserted central catheters [PICCs] and ports) and gastrointestinal fluoroscopy procedures (eg, upper gastrointestinal and contrast enema studies) were specifically targeted. Statistical analysis was performed. FT was recorded in 17,549 of 17,966 reports (98%) The 1393 procedures performed by nonphysician providers or transitional year interns were excluded. Residents, fellows, and faculty were primary operators in 5066, 6489, and 4601 procedures, respectively. Average FT (in seconds) for resident and fellow services, respectively, was less than that of faculty only for PICCs (75 and 101 vs 148, P < 0.01). For all other procedures, average FT of trainee services was greater than that for faculty. This was statistically significant (P < 0.05) for fellows vs faculty port placement (121 vs 87), resident vs faculty small bowel series (130 vs 96), and both resident and fellow vs faculty esophagram procedures (143 and 183 vs 126 ). FT for residents was significantly less than that for fellows only for PICCs (75 vs 101, P < 0.01). For most, but not all, fluoroscopy procedures commonly performed by radiology trainees, FT is greater than that for procedures performed by faculty radiologists. Better awareness and understanding of such differences may aid training programs in developing benchmarks, protocols, and focused teaching in the safe use of fluoroscopy for patients and operators.

摘要

评估放射科住院医师与放射科教员在进行常见血管通路和胃肠道检查时的透视时间(FT)差异。提取了两所大学医院在66个月内由住院医师或教员或两者共同进行的所有17966项索引透视检查服务的报告信息。具体针对各种血管通路检查(如经外周静脉穿刺中心静脉置管[PICC]和植入式静脉输液港)和胃肠道透视检查(如食管胃肠造影和钡剂灌肠检查)。进行了统计分析。17966份报告中有17549份记录了FT(98%),排除了由非医师提供者或过渡年实习生进行的1393项检查。住院医师、专科住院医师和教员分别是5066、6489和4601项检查的主要操作者。仅在PICC检查中,住院医师和专科住院医师服务的平均FT(以秒为单位)分别低于教员(75和101秒对148秒,P<0.01)。对于所有其他检查,住院医师服务的平均FT高于教员。在专科住院医师与教员的植入式静脉输液港放置检查(121秒对87秒)、住院医师与教员的小肠造影检查(130秒对96秒)以及住院医师和专科住院医师与教员的食管造影检查(143秒和183秒对126秒)中,这种差异具有统计学意义(P<0.05)。仅在PICC检查中,住院医师的FT显著低于专科住院医师(75秒对101秒,P<0.01)。对于放射科住院医师通常进行的大多数(但并非全部)透视检查,FT高于放射科教员进行的检查。更好地认识和理解这些差异可能有助于培训项目制定基准、方案,并在安全使用透视检查方面为患者和操作者开展有针对性的教学。

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