全髋关节置换术开展现状及继续教育对策研究

The Present Situation of Total Hip Arthroplasty and Continuing Medical Education

目的了解目前关节外科医师对全髋关节置换术掌握情况,进一步调整、提高我国全髋关节置换术继续教育提供指导。方法设计调查问卷,对参加2015年THA继续教育的医师进行调查,对调查结果统计、分析。结果二甲医院医师在THA术前与患者及家属积极沟通了解生活状态及术前模板测量人数比例分别为12.77%,14.89%,低于三甲医院医师的87.88%,84.85%(P<0.05);参与调查医师中有51.55%未开展THA翻修手术,其中主要为二甲医院医师;受调查医师对本次继续教育过程中的两种新型教学方式(模具操作、手术示范)医师认可率达到74.23%,而对于之后将课程分为初级、中级、高级及配备助教帮助解决问题的方式,接受医师比率为76.29%。结论我国THA手术已在基层广泛推广,但基层医师存在较为严重的手术不规范问题;我国关节外科医师对已经到来的大量THA翻修病例存在准备不足的情况;目前的THA继续教育课程获得了参加医师的认可,但仍无法满足不同层次医院医师的学习需求。

Objective To explore the mastery of total hip arthroplasty in joint surgeons from different degree hospitals and provide guidance for improving the continuing medical education of THA in china. Methods Applying designed questionnaire for surgeons attending the 2015 continuing medical education and analysis the data. Results Surgeons from Second-senior hospitals communicate less with patients and their relation with a rate of 12.77% than that in top three hospitals with a rate of 87.88%（P〈0.05）, The rate of preoperative templating in second-senior hospitals （14.89%） was also lower than that in top three hospitals（84.85%） （P〈0.05）. About 51.55% of surgeons questioned have not launched total revision THA, which contains surgeons from second-senior hospitals mostly. Approval rate of two new methods in education courses this time reaches 74.23%, while about 76.29% surgeons hope a grading class with more assistants to solve questions in the next courses. Conclusion THA has been carried on in primary hospitals, but surgeon technique is nonstandard. Joint surgeons have not totally prepared for the increasing revision THA patients. Our continuing medical education gets recognition from most surgeons, but still can not meets the full need of THA study.