外科培训课程对家庭医学医生办公室小型外科手术操作表现的影响：一项观察性研究。

Effect of surgical training course on performance of minor surgical procedures in family medicine physicians' offices: an observational study.

作者信息

Gmajnić Rudika, Pribić Sanda, Lukić Anita, Ebling Barbara, Cupić Nikola, Marković Ivana

机构信息

Department of FamilyMedicine, Osijek University School of Medicine, Osijek, Croatia.

出版信息

Croat Med J. 2008 Jun;49(3):358-63. doi: 10.3325/cmj.2008.3.358.

DOI:10.3325/cmj.2008.3.358

PMID:18581614

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2443620/

Abstract

AIM

To examine the influence of a practical surgical course on the number of minor surgical procedures performed by family physicians.

METHODS

We compared the number of minor surgical procedures performed by family physicians in 59 offices in the city of Osijek and surrounding rural area during 12 months before and after the 40-hour practical surgical course held in September 2006 by surgeons and family medicine specialists. Minor surgical procedures taught in the course included management of ingrown toenails, abscesses/comedones, and minor wounds, anesthesia application, disinfection, use and sterilization of surgical instruments, and antibiotic treatment.

RESULTS

The number of minor surgical procedures performed in family medicine offices almost doubled (503 vs 906 after the course, P<0.001, Wilcoxon test). The median number of abscesses/comedones treatments per physician increased from 1 to 6 (P<0.001, Wilcoxon test), the number of managed wounds increased from 111 to 217 (P<0.001, Wilcoxon test). The increase in ingrown toenail resections was also significant (from 120 to 186, P=0.004, Wilcoxon test). Fifty percent of physicians did not treat patients surgically, irrespective of the training. We found no association between the number of performed procedures and age, length of employment, or location of the physician's office (urban vs rural). However, we found that male physicians performed more surgical treatments both before and after the course (abscesses/comedones: P<0.001 and P=0.108 respectively; ingrown toenail resections: P=0.008 and P=0.008 respectively; minor wounds: P=0.030 and P<0.001; respectively).

CONCLUSION

Practical courses can encourage practitioners to treat the patients surgically in their offices and, thus, increase the number of services offered in primary care. Female physicians should be more encouraged to perform minor surgical procedures in their offices.

摘要

目的

探讨一门实践外科课程对家庭医生实施的小型外科手术数量的影响。

方法

我们比较了在2006年9月外科医生和家庭医学专家举办的40小时实践外科课程前后12个月期间，奥西耶克市及周边农村地区59个诊所的家庭医生实施的小型外科手术数量。该课程所教授的小型外科手术包括嵌甲处理、脓肿/粉刺处理、小伤口处理、麻醉应用、消毒、手术器械的使用和灭菌以及抗生素治疗。

结果

家庭医学诊所实施的小型外科手术数量几乎翻倍（课程前为503例，课程后为906例，P<0.001，Wilcoxon检验）。每位医生处理脓肿/粉刺的中位数从1例增加到6例（P<0.001，Wilcoxon检验），处理的伤口数量从111例增加到217例（P<0.001，Wilcoxon检验）。嵌甲切除术的增加也很显著（从120例增加到186例，P=0.004，Wilcoxon检验）。50%的医生无论是否接受培训都不进行外科手术治疗患者。我们发现实施的手术数量与医生年龄、从业年限或诊所位置（城市与农村）之间没有关联。然而，我们发现男性医生在课程前后实施的外科治疗都更多（脓肿/粉刺：分别为P<0.001和P=0.108；嵌甲切除术：分别为P=0.008和P=0.008；小伤口：分别为P=0.030和P<0.001）。