探讨基于动脉血气分析判读Excel电子表格临床路径在医学实习生酸碱平衡紊乱教学中的应用效果。

选取50名徐州市中心医院实习的2017级五年制临床医学专业学生为研究对象，其中男22名，女28名，年龄22~25岁。将50名学生按照随机数字表法分为试验组和对照组，每组25人。由新生儿重症监护病房（NICU）2名资历相似的高年资主治医师，分别对试验组和对照组进行教学，试验组采用动脉血气分析判读Excel表格设计思路的四步分析法进行临床路径教学，对照组采用经典动脉血气分析判断方法进行教学，比较两组学生教学培训后理论考核成绩、酸碱失衡判读的理解用时，以及师生对教学满意度问卷调查结果进行分析。

两组学生在性别、年龄、授课前测试成绩进行比较，差异均无统计学意义（均P＞0.05）。教学培训后试验组学生理论考核成绩［（93.4±5.1）分］高于对照组学生［（87.4±5.6）分］，试验组学生被激发兴趣的比率［84.0%（21/25）］高于对照组［44.0%（11/25）］，参与课堂满意度的比率［76.0%（19/25）］高于对照组［40.0%（10/25）］，在提高分析解决问题的能力方面的比率［92.0%（23/25）］高于对照组学生［56.0%（14/25）］，方便课后自主练习的比率［88.0%（22/25）］高于对照组［44.0%（11/25）］，差异均具有统计学意义（均P＜0.05）；对酸碱失衡判读的理解用时［（88.6±12.5）min］明显少于对照组［（121.6±24.1）min］，差异亦具有统计学意义（P＜0.05）。两组教师问卷调查带教效果比较无统计学差异（P＞0.05），但均认为基于血气分析判读Excel电子表格的临床路径辅助教学更有助于理论授课。

基于动脉血气分析判读Excel电子表格的临床路径有助于教师更好地实施酸碱平衡紊乱的教学，有利于学生对酸碱失衡的理解与判断。

To explore the application effect of clinical pathway based on Excel spreadsheet for arterial blood gas judgment and interpretation in teaching medical interns acid-base balance disorder.

Fifty five-year medical interns of grade 2017 in Xuzhou Central Hospital were enrolled in the study, including 22 males and 28 females, with an age ranging from 22~25 years. The students were divided into an experimental group and a control group according to the random number table method, with 25 students in each group. Two senior attending physicians with similar qualification from the neonatal intensive care unit (NICU) taught the experimental group and the control group, respectively. The experimental group was taught through the clinical pathway using the four-step analysis method with Excel spreadsheet design idea for arterial blood gas analysis, while the control group was taught using the classical arterial blood gas judgment method. The two groups were compared after training in terms of the theoretical examination score, the time spent on comprehending acid-base imbalance, and the results of the questionnaire survey on the satisfaction with teaching and learning.

There was no significant difference between the two groups in gender, age, and pre-test score (P＞0.05 for all). After training, compared with the control group, the experimental group had significantly higher theoretical examination score [(93.4±5.1) points vs (87.4±5.6) points], percentage of students with interest stimulated [84.0% (21/25) vs 44.0% (11/25)], percentage of students with a sense of active participation in the class [76.0% (19/25) vs 40.0% (10/25)], percentage of students with improved ability of analyzing and solving problems [92.0% (23/25) vs 56.0% (14/25)], and percentage of students with self-directed practice after class [88.0% (22/25) vs 44.0% (11/25)] (P＜0.05 for all), while the time spent on comprehending acid-base imbalance was significantly shorter in the experimental group than in the control group [(88.6±12.5) min vs (121.6±24.1) min, P＜0.05]. There was no significant difference in teaching effect between the two groups (P＞0.05); however, it was believed that the clinical pathway teaching based on Excel spreadsheet for arterial blood gas analysis and interpretation was more conducive to theoretical teaching.

Clinical pathway teaching based on Excel spreadsheet for arterial blood gas analysis and interpretation is helpful for teachers to better implement acid-base balance disorder teaching and for students to better understand and judge the types of acid-base imbalance.