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外科医生对择期手术后全身炎症反应术后标志物使用的态度。

Attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery.

作者信息

Dolan Ross D, McSorley Stephen T, McMillan Donald C, Horgan Paul G

机构信息

Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.

出版信息

Ann Med Surg (Lond). 2017 Jul 20;21:14-19. doi: 10.1016/j.amsu.2017.07.046. eCollection 2017 Sep.

Abstract

BACKGROUND

Cancer is responsible for 7.6 million deaths worldwide and surgery is the primary modality of a curative outcome. Postoperative care is of considerable importance and it is against this backdrop that a questionnaire based study assessing the attitudes of surgeons to monitoring postoperative systemic inflammation was carried out.

METHOD

A Web based survey including 10 questions on the "attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery" was distributed via email. Two cohorts were approached to participate in the survey. Cohort 1 consisted of 1092 surgeons on the "Association of Coloproctology of Great Britain and Ireland (ACPGBI)" membership list. Cohort 2 consisted of 270 surgeons who had published in this field in the past as identified by two recent reviews. A reminder email was sent out 21 days after the initial email in both cases and the survey was closed after 42 days in both cases.

RESULT

In total 29 surgeons (2.7%) from cohort 1 and 40 surgeons (14.8%) from cohort 2 responded to the survey. The majority of responders were from Europe (77%), were colorectal specialists (64%) and were consultants (84%) and worked in teaching hospitals (54%) and used minimally invasive techniques (87%). The majority of responders measured CRP routinely in the post-operative period (85%) and used CRP to guide their decision making (91%) and believed that CRP monitoring should be incorporated into postoperative guidelines (81%).

CONCLUSION

Although there was a limited response the majority of surgeons surveyed measure the systemic inflammatory response following elective surgery and use CRP measurements together with clinical findings to guide postoperative care. The present results provide a baseline against which future surveys can be compared.

摘要

背景

癌症在全球导致760万人死亡,手术是实现治愈效果的主要方式。术后护理至关重要,正是在这样的背景下,开展了一项基于问卷调查的研究,以评估外科医生对监测术后全身炎症的态度。

方法

通过电子邮件分发了一项基于网络的调查,其中包括10个关于“外科医生对择期手术后全身炎症反应术后标志物使用的态度”的问题。邀请了两个队列参与调查。队列1由“大不列颠及爱尔兰结直肠外科学会(ACPGBI)”成员名单上的1092名外科医生组成。队列2由最近两项综述确定的过去在该领域发表过文章的270名外科医生组成。在两种情况下,均在初始电子邮件发出21天后发送提醒电子邮件,两种情况下调查均在42天后结束。

结果

队列1中有29名外科医生(2.7%),队列2中有40名外科医生(14.8%)回复了调查。大多数回复者来自欧洲(77%),是结直肠专科医生(64%),是顾问医生(84%),在教学医院工作(54%),并使用微创技术(87%)。大多数回复者在术后常规测量CRP(85%),并使用CRP来指导他们的决策(91%),且认为CRP监测应纳入术后指南(81%)。

结论

尽管回复有限,但大多数接受调查的外科医生在择期手术后会测量全身炎症反应,并结合临床发现使用CRP测量结果来指导术后护理。目前的结果提供了一个基线,可用于与未来的调查进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e10d/5524306/59454167e8ed/gr1.jpg

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