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基层医疗中扳机指松解手术的组织能力、结果及益处:一项服务评估研究

Organisational capabilities, outcomes, and benefits of trigger finger release surgery in primary care: a service evaluation study.

作者信息

Rizvi Fahad, Rong Ryan Chen Wei, Ethan Kong Amos, Pui Joshua Wong Chun, Khambhayata Neal, Arya Dhriti, Kapasi Tariq, Wilson Philippe B

机构信息

NHS Willows Health, Leicester, UK.

NHS Leicester, Leicestershire and Rutland Integrated Care Board, Leicester, UK.

出版信息

BJGP Open. 2023 Dec 19;7(4). doi: 10.3399/BJGPO.2023.0031. Print 2023 Dec.

Abstract

BACKGROUND

Trigger finger is a common hand condition in which a finger is unable to fully extend owing to a thickening of the tendon and its sheath, causing the finger to lock in a bent position.

AIM

To assess the viability of carrying out trigger finger surgeries in NHS primary care in terms of clinician and patient acceptance, experience, and outcomes; and operational requirements of this service for wider application.

DESIGN & SETTING: A pilot study for a new service in primary care in Leicestershire, UK.

METHOD

A total of 214 trigger finger release surgery procedures were carried out between 22 August 2019 and 25 October 2022 by a single hand surgeon in a single primary care surgery. Data were analysed using information from SystmOne, which is a patient database linked with the NHS.

RESULTS

Thirty-two cases out of 214 (15.0%) experienced a wait time of <10 days from the GP referral to the first outpatient appointment (OPA). Out of 214 procedures, there were 26 (12.1%) postoperative complications that required follow-up action. Of the total number of cases where postoperative complications were identified, 13 cases required further follow-up action, while the remaining 13 did not have any identifiable further follow-up action and were regarded as closed cases thereafter.

CONCLUSION

Trigger finger release surgery in primary care offers an opportunity to reduce pressures on secondary care orthopaedic referrals, as well as offering patients faster and effective surgical treatment while utilising fewer NHS resources.

摘要

背景

扳机指是一种常见的手部疾病,由于肌腱及其腱鞘增厚,手指无法完全伸直,导致手指锁定在弯曲位置。

目的

从临床医生和患者的接受度、体验及结果,以及该服务更广泛应用的运营要求方面,评估在英国国家医疗服务体系(NHS)初级保健机构中开展扳机指手术的可行性。

设计与地点

英国莱斯特郡初级保健一项新服务的试点研究。

方法

2019年8月22日至2022年10月25日期间,一名手外科医生在一家初级保健外科诊所进行了总共214例扳机指松解手术。使用与NHS相关联的患者数据库SystmOne中的信息进行数据分析。

结果

214例中有32例(15.0%)从全科医生转诊到首次门诊预约(OPA)的等待时间<10天。在214例手术中,有26例(1第十二点1%)术后并发症需要后续处理。在确定有术后并发症的病例总数中,13例需要进一步后续处理,其余13例没有任何可识别的进一步后续处理,此后被视为结案病例。

结论

初级保健中的扳机指松解手术提供了一个机会,可减轻二级保健骨科转诊的压力,同时在利用较少NHS资源的情况下为患者提供更快、有效的手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea9/11176693/3479e78e0d8b/bjgpopen-7-0031-f1.jpg

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