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在军事医疗紧急情况下,由年轻的军医进行即时超声检查的实用性。

Usefulness of point-of-care ultrasound in military medical emergencies performed by young military medicine residents.

机构信息

Antenne Médicale de Mailly le Camp, Centre Médical des Armées de Mourmelon, Mailly le Camp, France.

Service d'accueil des urgences, Centre Hospitalier de Pont l'Abbé, Pont l'Abbé, France.

出版信息

BMJ Mil Health. 2020 Aug;166(4):236-239. doi: 10.1136/jramc-2018-001132. Epub 2019 Jan 13.

Abstract

INTRODUCTION

To evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.

METHODS

A prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).

RESULTS

Forty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0-5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).

CONCLUSION

POCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.

摘要

简介

评估经过短期培训的年轻军医在医疗急救诊断中使用即时超声检查(POCUS)的效果。

方法

在法国军队教学医院的急诊部门进行了一项前瞻性研究。两名年轻的军医接受了重点针对胆囊、肾脏和下肢静脉的超声培训。在临床检查后,他们使用视觉模拟评分(CP)从 0(肯定不能诊断)到 10(明确诊断)对其进行评估。同一名学生以相同的方式进行超声检查并赋值(UP)。CP 和 UP 之间的绝对差值即为超声诊断指数(UDI),如果 UP 比 CP 更接近最终诊断(POCUS 提高了诊断准确性),则为阳性,反之则为阴性(POCUS 降低了诊断准确性)。

结果

共纳入 48 名患者,进行了 48 次超声检查。其中 14 名患者(29%)存在本研究中的病理情况。平均 UDI 值为+3(0-5)。35 次超声检查(73%)的 UDI 值为阳性,12 次(25%)为零,仅 1 次(2%)为阴性。

结论

临床检查后进行的 POCUS 可提高年轻军医的诊断准确性。

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