针对我国关节外科医生主治医师阶段手术相关数据的调查分析  

Investigation and Analysis of Surgery Related Data in Fellowship⁃Trained Arthroplasty Surgeons after Graduation

作　　者：付君 徐驰 倪明 李想 张国强 郝立波 柴伟 陈继营 FU Jun;XU Chi;NI Ming;LI Xiang;ZHANG Quo-qiang;HAO Li-bo;CHAI Wei;CHEN Ji-ying(Department of Orthopaedics,the First Medical Centre,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心骨科,北京100853

出　　处：《骨科》2021年第5期456-461,共6页ORTHOPAEDICS

基　　金：北京市自然科学基金(7192194)。

摘　　要：目的通过问卷调查的方式收集数据,分析我国关节外科医生选择假体和手术入路的影响因素以及关节置换辅助技术的使用情况等。方法本研究采用电子表格调查问卷模式,调查人群设定为中青年关节外科副高及以上医师,使用Microsoft Excel软件对数据进行图表制作和统计分析。本次问卷调查由22个问题组成,包括当前国内关节外科医生毕业后主治医师阶段手术培训教育的环境和特点,每年初次和翻修全膝关节置换(total knee arthroplasty,TKA)以及全髋关节置换(total hip arthroplasty,THA)的病例数量,关节置换辅助技术的使用,手术方式和入路的选择,所使用关节假体的品牌,以及影响个人选择的因素。结果问卷通过网络链接的方式发出,共回收完成312份问卷。其中56%的受访医生所在单位每年至少完成200例关节置换手术。43%的受访医生每年至少进行50例TKA,58%的受访医生每年至少进行50例THA。74.5%和65.9%的受访医生初次TKA和THA 90%以上的病例会选择同一个厂家的假体。主治医师阶段的经历、个人经验的积累、单位和厂家是关节外科医生选择TKA和THA假体和手术入路最主要的影响因素。59.0%的受访医生使用了关节置换辅助技术,其中40.8%认为辅助关节技术影响其关节假体的选择。结论主治医师阶段的经历、个人经验的积累以及单位和厂家是国内关节外科医生选择假体和手术技术最主要的影响因素。Objective To collect data through questionnaire survey and to analyze the factorsinfluencing the choice of prostheses and surgical approaches and the use of assistive technologies forarthroplasty. Methods An electronic survey was sent to all surgeons who had completed adult reconstructionfellowships. The survey consisted of 22 questions regarding current practice characteristics, case volumes forprimary and revision total hip arthroplasty(THA) and total knee arthroplasty(TKA), use of assistivetechnologies, choice of surgical approach and implant design, factors influencing their choices, and theirinvolvement in implant selection. Results Questionnaires were sent by web link, and 312 were completed. Atleast 200 total joint arthroplasty per year were performed at centers in 56% respondents, 43% of respondentscompleted at least 50 TKAs and 58% at least 50 THAs annually. 74.5% and 65.9% respondents used a singlecompany’implant for more than 90% of primary TKA and THA, respectively. Experience of fellowship andindividual and effect of hospital and company were the major influencing factors of TKA and THA surgicalselections. 59.0% of surgeons used some assistive technology, of which 40.8% said this influenced their implantchoice. Conclusion This study demonstrates that experience of fellowship and individual and effect ofhospital and company are the most influencing factors for implant and technique selections among fellowship-trained arthroplasty surgeons.

关 键 词：全膝关节置换术 全髋关节置换术 主治医师手术培训 假体选择 手术入路 

分 类 号：R687.4[医药卫生—骨科学]