Schulz C, Kunz U, Mauer U M, Mathieu R
Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
Orthopade. 2016 Apr;45(4):341-8. doi: 10.1007/s00132-015-3195-8.
From July 2007 to October 2014, neurosurgical services have been continuously available in a multinational Role 3 combat support hospital in Mazar-e-Sharif (MeS), Afghanistan. In this paper, we analyze a 7-year operative and outpatient spinal surgery caseload experience.
The overall annual and monthly caseloads were determined. Additionally, the surgical cases were differentiated relating to the strength of the indication, the location of the surgical site, and the origin of the patients. The outpatient caseload and spectrum of the years 2012 and 2013 were also analyzed.
A total of 341 surgeries were performed and 188 of them were spinal surgeries (55.1 %). The vast majority of surgeries were performed for degenerative diseases (127/188; 67.6 %). The proportion of fractures and penetrating injuries (61/188; 32.4%) increased over the observation period. Eighty percent of the immediate and urgent surgeries (within 12 h; n = 70) were performed for these indications. 19.8 % of the surgeries were done as an emergency, whereas 17.3 % had delayed urgency, and 62.9 % were elective procedures. Of the 1026 outpatient consultations documented, 82 % of them were related to spinal diseases.
The overall caseload in addition to the distribution of location, strength of indication, and patient origin for MeS are significantly lower than that reported by other International Security Assistance Force (ISAF) nations in eastern and southern Afghanistan. In addition, the rate of elective surgeries and those carried out in civilian Afghan patients is highest in MeS. In comparison with MeS, none of the other ISAF military hospitals shows such a strong concentration of degenerative spinal conditions in their surgical spectrum. Nevertheless, the changing pattern of spine-related diagnoses and surgical therapies in the current conflict represents a challenge for future educational and material planning in comparable missions.
2007年7月至2014年10月，阿富汗马扎里沙里夫（MeS）的一家多国三级战斗支援医院持续提供神经外科服务。在本文中，我们分析了7年的脊柱手术手术量及门诊量经验。
确定了总体年度和月度工作量。此外，手术病例根据适应证强度、手术部位及患者来源进行区分。还分析了2012年和2013年的门诊量及病种范围。
共进行了341例手术，其中188例为脊柱手术（55.1%）。绝大多数手术是针对退行性疾病进行的（127/188；67.6%）。在观察期内，骨折和穿透伤的比例（61/188；32.4%）有所增加。80%的紧急和急诊手术（12小时内；n = 70）是针对这些适应证进行的。19.8%的手术为急诊手术，17.3%为延迟急诊手术，62.9%为择期手术。在记录的1026次门诊咨询中，82%与脊柱疾病有关。
MeS的总体工作量以及手术部位、适应证强度和患者来源的分布显著低于阿富汗东部和南部其他国际安全援助部队（ISAF）国家报告的数据。此外，MeS的择期手术率以及在阿富汗平民患者中进行的手术率最高。与MeS相比，其他ISAF军事医院在其手术范围内均未表现出如此强烈的退行性脊柱疾病集中情况。然而，当前冲突中与脊柱相关的诊断和手术治疗模式的变化对未来类似任务中的教育和物资规划构成了挑战。
