成人泌尿科医生在儿童护理中的作用：英国一项调查的结果

Thomas D F, Fraser M

Leeds Teaching Hospitals, Leeds, UK.

BJU Int. 2001 Jul;88(1):80-3. doi: 10.1046/j.1464-410x.2001.02245.x.

OBJECTIVE

To document the current role of adult urologists in the care of children in the UK and to consider the future provision of urological services for children within the context of published national guidelines.

METHODS

A detailed postal questionnaire was sent to all 416 consultant urologists listed as full members of the British Association of Urological Surgeons and resident in the UK. The range of information sought from each urologist included details of personal paediatric training, scope of personal practice, and information about facilities and provision of urological services for children in their base National Health Service hospital.

RESULTS

The response rate was 69%; most consultant urologists (87%) in District General Hospitals (DGHs) undertake paediatric urology, mainly routine procedures of minor or intermediate complexity. Of urologists in teaching hospitals, 32% treat children but their involvement is largely collaborative. Consultants appointed within the last 10 years are less willing to undertake procedures such as ureteric reimplantation or pyeloplasty than those in post for > or = 10 years. Currently, 18% of DGH urologists hold dedicated children's outpatient clinics and 34% have dedicated paediatric day-case operating lists. Almost all urologists practise in National Health Service hospitals which meet existing national guidelines on the provision of inpatient surgical care for children.

CONCLUSION

Urologists practising in DGHs will retain an important role as providers of routine urological services for children. However, the tendency for recently appointed consultants to limit their practice to the more routine aspects of children's urology is likely to increase. Training and intercollegiate assessment should focus on the practical management of the conditions most commonly encountered in DGH practice. The implementation of national guidelines may require greater paediatric subspecialization at DGH level to ensure that urologists treating children have a paediatric workload of sufficient volume to maintain a high degree of surgical competence.

目的

记录英国成年泌尿科医生在儿童护理中的当前作用，并结合已发布的国家指南考虑未来儿童泌尿科服务的提供情况。

方法

向英国泌尿外科学会所有416名列为正式会员且居住在英国的顾问泌尿科医生发送了一份详细的邮政调查问卷。从每位泌尿科医生那里获取的信息范围包括个人儿科培训细节、个人业务范围，以及关于其所在基础国民保健服务医院儿童泌尿科服务设施和提供情况的信息。

结果

回复率为69%；大多数地区综合医院（DGH）的顾问泌尿科医生（87%）从事小儿泌尿外科工作，主要是进行复杂性较低或中等的常规手术。在教学医院的泌尿科医生中，32%治疗儿童，但他们的参与主要是协作性的。过去10年内任命的顾问比任职10年及以上的顾问更不愿意进行输尿管再植术或肾盂成形术等手术。目前，18%的DGH泌尿科医生设有专门的儿童门诊，34%有专门的儿科日间手术安排。几乎所有泌尿科医生都在符合现有国家儿童住院手术护理指南的国民保健服务医院执业。

结论

在DGH工作的泌尿科医生将继续作为儿童常规泌尿科服务提供者发挥重要作用。然而，最近任命的顾问将业务局限于小儿泌尿外科更常规方面的趋势可能会增加。培训和校际评估应侧重于DGH实践中最常见病症的实际管理。国家指南的实施可能需要在DGH层面进行更大程度的儿科亚专业划分，以确保治疗儿童的泌尿科医生有足够数量的儿科工作量来维持高度的手术能力。