回顾过去瞻望未来——庆祝我国介入学组成立二十周年

对我国介入学组成立20周年作简单回顾,对今后发展表达个人的看法.建议建立学组的常设机构;介入医师要能全程管理自己患者,成为真正的临床医师,开展多种微创介入治疗;提高科研水平;健全介入医学的教学、培养与晋升制度;加强发展介入队伍;提高"介入放射学杂志"地位与水平;提高学术活动质量;强化学科体制建设;正确对待学科间的竞争;做好介入自身工作.     

介入专科医师规范化培训探索

【摘要】 介入放射学是在放射影像诊断学基础上发展起来的一门新兴的影像引导微创诊疗学,涉及多个临床学科。目前我国尚未建立规范化的介入放射学人才培养体系。本文介绍北京大学医学部开展介入专科医师规范化培训试点工作情况,包括介入科室现状调研、培训方案和考核方案等,为建立介入专科医师培训体系作一尝试。     

重视儿科介入放射学

介入放射学在儿童疾病的诊治中有广泛的用武之地。儿科介入放射学是介入放射学的一个分支学科,也是儿科放射学的一个分支学科。儿科介入放射学在近30年来发展迅速,在发达国家,儿科介入放射医师现在与儿童内、外科医师紧密合作,诊断和治疗范围广泛的各种儿童疾病。儿科介入放射学内容包括儿童心脏介入放射学,儿童神经介入放射学,儿童血管介入放射学,儿童非血管介入放射学,儿童肿瘤介入放射学等[1-5]。在美国,每所200张床位以上的儿童医院中,都有专门从事儿科介入放射学的医师,放射科都有自己专用的DSA血管造影设备。在这些医院中每年都实施…     

《介入放射治疗——患者必读》书评

目前,"介入放射学"在我国已被公认为与"内科学"、"外科学"并列的三大临床学科之一.具有微创性和靶向性等特点的介入放射治疗技术已达到或接近国际水平,临床已广泛用于治疗许多疾病,不仅能明显提高疗效,还可使患者爱到的损伤和痛苦减到最小程度.     

关于介入放射学科定位危机和重命名的思考

自 1 964年Ｄｏｔｔｅｒ完成首例ＰＴＡ术及 1 967年Ｍａｒｇｕｌｉｓ首次提出介入放射学的概念以来 ,这门临床医学中的新兴学科取得了长足的进步与发展 ,已成为现代医学诊疗中不可缺少的重要环节 ,并有望成为临床医疗中与内、外科并列的第三大支柱学科。作为一门临床学科 ,介入放射学在临床日常医疗工作中所起的作用有目共睹 ,已成为临床各科医患常愿选择的诊断和治疗手段。然而 ,介入放射学是否真正被临床各学科认可和广大患者所接受 ?回答并不肯定。例如 :尽管不少医院已开设了介入放射门诊 ,但是直接挂号来就诊的患者却寥寥无几 ;笔者曾…     

全身麻醉在神经介入手术中的应用进展

近10年来,随着各种介入放射学诊断与治疗技术的发展,越来越多的复杂介入手术逐渐开展起来,并应用于各种患者,对患者配合度的要求也越来越高,因此麻醉也被越来越多地应用到介入操作和患者处理之中,向麻醉医师提出了更多挑战.本文对全身麻醉在神经介入放射学领域的研究进展、临床应用、操作步骤、与清醒镇静的比较及并发症等做一综述.     

浅谈介入放射医师临床能力的培养与介入病房的管理

尽管介入放射学是近 2 0年来发展起来的一门新兴学科。但在临床医学中 ,介入治疗已经成为与内科、外科并列的第三大治疗手段。目前 ,介入放射学正处于迅速发展与广泛普及阶段 ,越来越多的医院成立介入病房。这不仅为介入放射学的研究与发展提供更有利的条件 ,同时也向介入放射医师提出更高的要求 ,在医疗市场竞争日趋激烈 ,介入放射学专业尚未完全成熟的今日 ,提高自身的临床工作与管理能力 ,是使介入放射学走向可持续发展的必须重视的问题[1] 。根据我院介入病房成立后数年来介入病房工作与管理的体会 ,总结出如下介入医师培养及介入病房管…     

介入放射学人才培养的几点体会

随着介入放射学在医学中重要性的提高,介入放射学人才的培养成为当务之急,因为人才是学科发展的根本,介入放射学同样对队伍有严格的要求,要开展和发展介入放射学必须有一支高素质的介入诊疗队伍。介入医师必须具备丰富的临床知识、放射影像学知识及熟练的介入操作技能;介入技术队伍必须具有丰富的放射设备维修知识及熟练操作机器的能力,并具有一定介入医学基础知识;介入护理人员还应具有介入专科护理知识。可见介入放射学对其人才要求很严格。     

我国儿科介入放射学现状及展望

儿科介入放射学是介入放射学与儿科放射学的重要分支,因疗效显著和创伤较小而深受临床医师与患儿家长的欢迎。但该学科在我国尚未得到广泛开展。本文评述我国儿科介入放射学的发展现状,临床诊治过程中的特殊性,以及未来发展中存在的问题。     

浅谈介入放射医师综合素质

1　介入放射学概况介入放射学是近年迅速发展起来的一门融医学影像学和临床治疗学于一体的边缘学科。目前 ,介入放射医师已能把导管或器械“介入”到人体几乎所有的血管分支 ,消化道和其他特定部位。在影像学方法引导下 ,采取经皮穿刺插管 ,对患者进行血管造影 ,采集病理学、细胞学、生化学检查资料 ,进行药物灌注 ,血管栓塞或扩张成形及体腔引流等“非外科手术”方法诊断和治疗多种疾病。其特点是简便、安全、有效、微创和并发症少。许多介入方法成为了主要的治疗手段 ,甚至取代或淘汰了原来的外科手术。介入放射学发展与普及 ,不仅引起医…     

Radiology as part of an objective structured clinical examination on clinical skills

Introduction

An objective structured clinical examination (OSCE) assessess clinical competence in a standardised and context related manner. Compared with written tests, OSCE's are more susceptible to reliability errors because of the use of multiple cases and multiple examiners. In the pre-clinical phase of the medical curriculum of the University Medical Centre Utrecht, an OSCE is organised as a medical consult. We evaluated the radiology station.

Method

Four questions were formulated:

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What is the internal consistency of the items of the radiology station?

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How do the scores on the radiology station compare with the scores on the test excluding radiology?

•

How do different cases differ in scores?

•

What are the differences in score between the examiners?

We analysed the OSCE results of second year medical students in 2004.

Results

Two hundred and sixty-five students were examined in the OSCE in 2004. Ninty-three Students were examined in the radiology station. Cronbach's alpha coefficient for the radiology station was 0.92. The average score for the radiology station was 3.8 (0.87). The average score for the test without radiology was 3.9 (0.32). The range of the average scores for the six different cases was 0.5 (3.6-4.1). The range of the average scores for the five examiners was 1.0 (3.3-4.3).

Conclusion

The internal consistency of the items in the radiology station is good. The average score for the radiology station is similar to that of the other stations. The range of the scores between the different cases was relatively small. The range of the scores between the different examiners was clearly larger.     

Evaluation of a workshop to teach clinical bioethics in the clinical setting

That the teaching of medical ethics must extend into the clinical years in order for medical students to effectively acquire the knowledge and skills required for dealing with clinical bioethical issues has been widely recognized. A limiting factor has been the lack of physicians able to teach bioethics in the clinical setting. This paper describes the structure and evaluation of a workshop for teaching clinicians how to teach bioethics in the clinical setting. 80 physicians participated in 4 workshops in which they were provided with the ethical principles needed to deal with clinical bioethical issues and appropriate teaching methods. Methods such as paper cases, videotaped standardized patient interactions and live standardized patients were presented. The workshops have been highly evaluated. Post workshop evaluation showed that a significant number of physicians taught ethical issues during rounds and seminars. The frequency of teaching ranged from once per month to one or more times per week.