Frimpong-Ansah K, Kirkby G R
Vitreo-Retinal Fellow, Birmingham & Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK.
Eye (Lond). 2002 Nov;16(6):754-60. doi: 10.1038/sj.eye.6700326.
To ascertain the current provision of facilities for the management of vitreo-retinal (V-R) emergencies, and attitudes of V-R surgeons towards the management of V-R emergencies within the United Kingdom and Eire.
To obtain this information, all 82 consultant members of the Britain and Eire Association of Vitreo-Retinal Surgeons (BEAVRS) were requested to complete a 14-part postal questionnaire in the year 2000. Seventy-eight questionnaires were completed and returned. Data from the questionnaires were collated on a Microsoft Access Database and then statistically analysed using SPSS. The Student's t-test was used to assess relationships between continuous variables, and the Chi-squared and Fisher's Exact tests were used to compare non-parametric data. Analyses of the first 13 parts of the questionnaire are presented in this report.
The majority of V-R surgeons (59%) practise in teaching hospitals. There are greater numbers of V-R surgeons per unit in teaching hospitals as compared to District General Hospitals (DGHs). Ophthalmic theatre and ophthalmic theatre staff availability are theoretically high (92.3% and 84.6% respectively) and evenly distributed between teaching hospitals and DGHs, but in reality, access may be difficult. Most V-R surgeons take part in an on-call rota with general ophthalmology colleagues. This formal commitment may be infrequent. Only a small proportion of V-R surgeons (28.3%) officially provide a continuous fixed on-call V-R rota, though in practice, a larger proportion do seem to provide this type of cover informally. Most V-R fellows are located in teaching hospitals (89.5%), and are usually on either a formal or informal on-call rota. Only one unit has a formal continuous on-call rota for fellows allowing no more than 72 hours duty per week. The mean time given in response to the question as to the ideal time within which surgery of an acute macula on supero-temporal retinal detachment should be carried out was 29 hours. Most V-R surgeons would not support, in court, a colleague whose patient lost vision through delay in treating a macula on detachment.
The findings of this survey have important implications for providing a reliable service and for proper cover for doctors in training.
确定目前英国和爱尔兰玻璃体视网膜（V-R）急症管理设施的配备情况，以及V-R外科医生对V-R急症管理的态度。
为获取这些信息，2000年要求英国和爱尔兰玻璃体视网膜外科医生协会（BEAVRS）的所有82名顾问成员填写一份包含14个部分的邮寄问卷。共收到并返回了78份问卷。问卷数据整理到Microsoft Access数据库中，然后使用SPSS进行统计分析。采用学生t检验评估连续变量之间的关系，采用卡方检验和Fisher精确检验比较非参数数据。本报告展示了问卷前13个部分的分析结果。
大多数V-R外科医生（59%）在教学医院执业。与地区综合医院（DGHs）相比，教学医院中每单位的V-R外科医生数量更多。理论上眼科手术室和眼科手术室工作人员的可利用性较高（分别为92.3%和84.6%），且在教学医院和DGHs之间分布均匀，但实际上可能难以使用。大多数V-R外科医生与普通眼科同事一起参与值班轮班。这种正式的值班安排可能并不频繁。只有一小部分V-R外科医生（28.3%）正式提供持续固定的V-R值班轮班，不过实际上，有较大比例的医生似乎在非正式地提供这种类型的值班服务。大多数V-R进修医生在教学医院工作（89.5%），通常参与正式或非正式的值班轮班。只有一个单位为进修医生提供正式的持续值班轮班，每周值班时间不超过72小时。对于颞上视网膜脱离合并急性黄斑病变的手术应在多长时间内进行这一问题，给出的平均时间为29小时。大多数V-R外科医生在法庭上不会支持因黄斑脱离治疗延误导致患者失明的同事。
本次调查结果对于提供可靠的服务以及为实习医生提供适当的值班安排具有重要意义。
