我国腹股沟疝手术规范化和质量控制存在的问题及对策

The standardization implementation and quality control specification of inguinal hernia surgery in China

腹股沟疝的治疗在近20年得到快速发展,由中华医学会外科学分会疝和腹壁外科学组修订的《成人腹股沟疝诊疗指南(2014版)》对新时期我国腹股沟疝诊疗提出了更高、更细致的要求。但目前我国疝外科发展极不均衡,仍有很多地区在手术规范化方面存在一系列问题,包括概念混乱、手术指征不清、技术应用不规范、材料选择不当,并由此导致的并发症增加(尤其是严重并发症)病例近年来在各级别会议中均有报道。如何对这些手术进行规范和质量标准控制也是关乎到我国现阶段腹股沟疝事业发展的重要因素。随着一部分可量化的质控指标被引入到行业质量控制体系中,以及由政府主导、医院为主体的疝病病人注册系统的逐步建立,可以预见,我国腹股沟疝手术质量控制的工作必将迎来全面发展,这也促使疝外科从业人员更好地完成腹股沟疝的日常诊疗工作,最终使病人获益。

The therapy of inguinal hernia has developed so rapidly in recent ten years in China. The China Hernia Society （CHS） modified and published the Guideline for diagnosis and treatment in inguinal hernia in adults in 2014,which set up a higher standard of inguinal hernia therapy. Still we had a series of problems in the standardization of hernia surgery in many places in our country and we can justify some chaos,such as confused concepts and indicator,nonstandard technology implementation,impertinent material choices,leading to huge increasing complications （especially some serious complications）.The QCS （Quality control standardization） system is very important in inguinal hernia surgery nowadays. With the quantifiable quality control index induced and the registry system for inguinal hernia patients developed,the QCS would have an outburst in a few years,result from the care result from the skillful of hernia specialist and their effectiveness for their patients.