| 摘要: |
| 目的 评价基于5G超声机器人及专家会诊系统的2种远程超声模式在急诊超声检查中的初步应用效果。方法 选择2019年9月海军军医大学（第二军医大学）第二附属医院急诊重症医学科ICU病区病情平稳的患者及其他志愿者共10人，先由门诊超声医师远程操作5G超声机器人（远程超声模式1）对受检者按照胸腹部扩展的创伤重点超声评估（EFAST）检查流程采集7个标准切面图像，然后由急诊医师在门诊超声医师远程会诊系统指导下（远程超声模式2）按EFAST检查流程采集相同切面图像。对比2种远程超声模式下超声图像获取的难易度、操作者满意度、受检者体验度评分、图像质量、阳性检出和漏诊情况、检查时间。结果 利用仰卧位左上腹纵切面扫查左侧前下胸壁及脾肾间隙时，远程超声模式1超声图像获取的难度较远程超声模式2高，操作者满意度较远程超声模式2低[（6.20±0.79）分vs（6.95±0.80）分、（5.95±0.72）分vs（6.75±0.89）分，P＝0.049、0.041]；仰卧位扫查右侧前上胸壁时，远程超声模式1超声图像获取的难度较远程超声模式2低[（7.40±0.57）分vs（6.60±0.70）分，P＝0.012]。远程超声模式1下受检者的紧张度高于远程超声模式2下受检者的紧张度[（4.95±0.98）分vs（3.30±0.86）分，P＜0.001]。远程超声模式1、远程超声模式2所采集的图像质量总得分差异无统计学意义[（29.90±0.51）分vs（29.50±0.46）分，P＝0.270]。10名受检者中6例有阳性发现，远程超声模式1检出5例、漏诊1例，远程超声模式2检出4例、漏诊2例。远程超声模式1的检查时间长于远程超声模式2[（8.30±0.89）min vs（4.20±0.98）min，P＜0.001]。结论 基于5G超声机器人及专家会诊系统的2种远程超声模式在快速胸腹部超声检查的急诊临床应用中有一定价值，可辅助一线急诊医师快速检伤分类并实时提供超声预诊断指导。 |
| 关键词: 第五代移动通信技术 超声机器人 专家会诊系统 远程超声 扩展的创伤重点超声评估 |
| DOI：10.16781/j.CN31-2187/R.20211237 |
| 投稿时间：2021-12-08修订日期：2022-03-08 |
| 基金项目:海军军医大学(第二军医大学)第二附属医院人才建设三年行动计划——"金字塔"人才工程军事医学人才项目,2017年度海军军医大学(第二军医大学)教改立项项目(JYC2017040) |
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| Two remote ultrasound modes based on 5G ultrasound robot and expert consultation system in emergency ultrasound examination: preliminary application |
| CHEN Rui1,2,ZHAO Jia-qi1*,MA Lin-hao3 |
(1. Department of Ultrasound, The Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200003, China;
2. Department of Ultrasound, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
3. Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| ObjectiveTo evaluate the preliminary application of 2 remote ultrasound modes based on 5G ultrasound robot and expert consultation system in emergency ultrasound examination.MethodsA total of 10 subjects, including stable patients and other volunteers, in the intensive care unit (ICU) of Department of Emergency and Critical Care Medicine of The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) were enrolled in Sep. 2019. The 5G ultrasound robot (remote ultrasound mode 1) was remotely operated by an outpatient ultrasound physician to collect 7 standard sectional images of the subjects according to the thoracoabdominal extended focused assessment with sonography for trauma (EFAST) examination process, and then the same sectional images were collected by an emergency physician under the remote guidance of ultrasound expert consultation system (remote ultrasound mode 2) following the EFAST process. The difficulty of acquiring ultrasonic images, operator satisfaction, experience score of subjects, image quality, positive detection and missed diagnosis, and examination time under the 2 remote ultrasound modes were compared.ResultsWhen scanning the left anterior lower chest wall and splenorenal space with the left upper abdominal longitudinal section in supine position, the difficulty of obtaining ultrasonic images in the remote ultrasound mode 1 was significantly higher than that in the remote ultrasound mode 2, and the operator satisfaction was significantly lower than that in the remote ultrasound mode 2 (6.20±0.79 vs 6.95±0.80, 5.95±0.72 vs 6.75±0.89, P＝0.049, 0.041). When scanning the right anterior superior chest wall in supine position, the difficulty of acquiring ultrasonic images in the remote ultrasound mode 1 was significantly lower than that in the remote ultrasound mode 2 (7.40±0.57 vs 6.60±0.70, P＝0.012). The tension of subjects in the remote ultrasound mode 1 was significantly higher than that in the remote ultrasound mode 2 (4.95±0.98 vs 3.30±0.86, P < 0.001). There was no significant difference in the total score of image quality acquired by the 2 remote ultrasound modes (29.90±0.51 vs 29.50±0.46, P＝0.270). Among the 10 subjects, 6 had positive findings. Five were detected and 1 was missed in the remote ultrasound mode 1; 4 were detected and 2 were missed in the remote ultrasound mode 2. The examination time of the remote ultrasound mode 1 was significantly longer than that of the remote ultrasound mode 2 ([8.30±0.89] min vs [4.20±0.98] min, P < 0.001).ConclusionThe 2 remote ultrasound modes based on 5G ultrasound robot and expert consultation system are valuable in the emergency clinical application of rapid thoracoabdominal ultrasound examination, and can assist the first-line emergency physicians to quickly detect and classify injuries and provide real-time guidance on ultrasound pre-diagnosis. |
| Key words: 5th generation mobile communication technology ultrasound robot expert consultation system remote ultrasound extended focused assessment with sonography for trauma |
