摘要目的 通过对国内三级医院急诊科即时超声检查设备拥有和使用情况进行调查,以了解国内急诊科床旁超声的普及情况.方法 采用网络问卷调查的方式,对全国三级医院急诊科超声仪器拥有量、超声检查技术掌握情况、探头消毒方法等进行调查.结果 2018年9月至12月问卷链接点击量共2 994次,回收有效问卷718份,去除重复及非三级医院问卷后,最终问卷调查涵盖三级医院300家,其中三级甲等医院250家(83.3%).急诊科拥有即时超声仪器的医院有173家(57.7%),其中122家(40.6%)仅拥有1台床旁超声检查仪器.超声设备来源主要是科室购入新机器(119家,68.8%)、超声科淘汰的旧机器(38家,22.0%)、向超声科/厂家租借(42家,24.3%)3种途径.300家应答医院中,急诊科无人掌握超声检查技术的医院有92家(占30.7%),掌握床旁超声检查技术医师比例在1%～25%的医院占52.7%.独立行急诊床旁即时超声检查收费的医院有52家(占30.1%).日常探头的主要清洁方法为清洁干纸巾擦拭(97家,56.1%),必要时用消毒纸巾(69家,39.9%)、专门的探头消毒剂(23家,13.3%)和探头保护套及无菌凝胶(12家,6.9%)等;79家(占45.7%)无常规的探头消毒措施.行超声引导穿刺时,保持穿刺部位无菌的方法主要为使用无菌的手套和生理盐水(106家,61.3%)、一次性无菌探头保护套和无菌耦合剂(55家, 31.8%).结论 国内三级医院急诊科床旁超声拥有率和即时超声检查技术掌握率有待提升,探头清洁需要得到重视和改善.

abstractsObjective To investigate the possession of ultrasound equipment and use of point-of-care ultrasound (POCUS) in emergency department of tertiary hospitals in China to figure out the present condition of POCUS in the emergency department. Methods Questionnaire survey was performed through the internet, which included equipment possession, usage, and the sterile technique of the probe in the emergency department of tertiary hospitals. Results Between September and December in 2018, a total of 2 994 questionnaires link was clicked, and 718 survey responses were collected. After removing duplicated and non-tertiary hospitals questionnaires, the final questionnaire survey covered 300 tertiary hospitals, of which 250 were tertiary A hospitals (83.3%). The number of emergency department which own bedside ultrasound machine was 173 (57.7%), 40.6% (122) of the departments had only one ultrasonic machine. The main sources of equipment were new bought machines (119, 68.8%), given (38, 22.0%) or rented old machines from the ultrasound department (42, 24.3%). None of the emergency physicians in 92 (30.7%) departments mastered the POCUS skills, and 52.7% of the response hospital had less than a quarter emergency physicians grasp the skills. Fees of the POCUS could be charged in 52 (30.1%) of them. The main methods to clean or sterilize the probes were to wipe the probe by cleaning dry paper (97, 56.1%), sterile wet paper (69, 39.9%) or special probe disinfector (23, 13.3%), and used probe protective sleeve and sterile gel (12, 6.9%) as necessary; 79 (45.7%) departments had no conventional probe disinfection measures. When the ultrasonic was used to guide the punctures, the prevention of infection policies were the sterile gloves and saline (106, 61.3%), disposable probe protective sleeve and sterile gel (55, 31.8%). Conclusions The propagation of POCUS in emergency department is needed to develop in tertiary hospitals in China. The right way to clean the probes need to be emphasized.