Bath Michael, Bashford Tom, Fitzgerald J E
Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK.
NIHR Global Health Research Group on Neurotrauma, Division of Anaesthesia, University of Cambridge, Cambridge, UK.
BMJ Glob Health. 2019 Oct 30;4(5):e001808. doi: 10.1136/bmjgh-2019-001808. eCollection 2019.
'Global surgery' is the term adopted to describe a rapidly developing multidisciplinary field aiming to provide improved and equitable surgical care across international health systems. Sitting at the interface between numerous clinical and non-clinical specialisms, it encompasses multiple aspects that surround the treatment of surgical disease and its equitable provision across health systems globally. From defining the role of, and need for, optimal surgical care through to identifying barriers and implementing improvement, global surgery has an expansive remit. Advocacy, education, research and clinical components can all involve surgeons, anaesthetists, nurses and allied healthcare professionals working together with non-clinicians, including policy makers, epidemiologists and economists. Long neglected as a topic within the global and public health arenas, an increasing awareness of the extreme disparities internationally has driven greater engagement. Not necessarily restricted to specific diseases, populations or geographical regions, these disparities have led to a particular focus on surgical care in low-income and middle-income countries with the greatest burden and needs. This review considers the major factors defining the interface between surgery, anaesthesia and public health in these settings.
“全球外科”是一个用来描述快速发展的多学科领域的术语，该领域旨在在国际卫生系统中提供更高质量且公平的外科治疗。它处于众多临床和非临床专业的交叉点，涵盖了围绕外科疾病治疗及其在全球卫生系统中公平提供的多个方面。从界定最佳外科治疗的作用和需求，到识别障碍并实施改进，全球外科的职责范围很广。倡导、教育、研究和临床等方面都可能涉及外科医生、麻醉师、护士以及与包括政策制定者、流行病学家和经济学家在内的非临床人员合作的相关医疗保健专业人员。作为全球和公共卫生领域中一个长期被忽视的主题，国际上对极端差距的日益认识促使更多人参与进来。这些差距不一定局限于特定疾病、人群或地理区域，导致特别关注负担最重且需求最大的低收入和中等收入国家的外科治疗。本综述探讨了在这些背景下界定外科、麻醉与公共卫生之间交叉点的主要因素。
