健康中国2030 重症医学直面挑战责无旁贷——中国重症医学40年大事记

Healthy China 2030 critical care medicine: challenges accepted--40-year-chronicle of critical care medicine in China

早在1974年8月,在中国就出现了以独立医疗单元抢救危重患者的"三衰(心、肺、肾)"抢救病房.到20世纪80年代,中国的重症医学专业发展迅速,不论是在日常的医疗工作还是在一系列突发公共卫生事件中,都彰显出其独特的学术地位和优势.1989年9月4日,世界危重病医学会联盟(WFSICCM)接纳中国中西医结合研究会危重病医学专业委员会(TCMWMCSCCM)为正式成员国学会;1989年11月,原国家科委批准在天津创办了国内第一本危重病医学杂志——《危重病急救医学》(Critical Care Medicine),表明我国的危重病医学已经正式被国际社会接纳并确定了自己的学术地位.1997年9月中国病理生理学会成立危重病医学专业委员会,2005年3月中华医学会成立重症医学分会,2009年7月中国医师协会成立重症医学医师分会.2008年国家标准委员会确定重症医学为临床医学二级学科(学科代码320.58),2009年重症医学科列入临床一级诊疗科目(代码28).2001年中国病理生理学会危重病医学专业委员会也正式加入WFSICCM和亚太危重病医学协会(APACCM)并成为理事成员国学会,2006至2010年中国病理生理学会危重病医学专业委员会分别成为APACCM、WFSICCM和全球脓毒症联盟(GSA)主席国和理事成员国学会,至今,我国还有多位重症医学学者担任国际学术组织的理事.2012年在葡萄牙里斯本召开的欧洲重症医学会学术年会(ESICM LIVES 2012),中国病理生理学会危重病医学专业委员会受邀组团代表中国参加年会并授课,展示了我国重症医学学者的风采.2013年起,中华医学会重症医学大会开设中美、中欧联合论坛至今,2018年举行了"一带一路"学术活动启动仪式,与"一带一路"沿线18个国家和地区的重症医学学术团体签订友好合作协议,并建立长久的交流与合作关系,表明中国的重症医学参与国际融合已进入了良性发展的轨道.2019年是中国重症医学建设和发展40年.今天中国重症医学已是日渐腾飞,在崭新的学科平台上飞速发展,走上了专业化、规范化发展道路,取得了一系列学科发展成果,也获得了世界同行的称赞.中华医学会重症医学分会自2005年3月成立以来,每年举办的学术年会规模逐渐扩大,参会人员从1 000多人逐渐增加到1.5万余人,投稿篇数从几百篇到几千篇,显示我国的重症医学发展到了空前的规模;同时,重症医学分会通过发表系列专业指南、技术规范及学术年鉴,实施重症医学专科资质培训(5C培训)、开展继续教育项目、举办重症医学基层行活动、设立"终身成就奖"等一系列举措,推进中国重症医学事业不断进步和发展.中国医师协会重症医学医师分会在推动我国重症医学专科医师培训方面也作出了很大的贡献,并推动了我国重症医学专科规范化培训的进程.2018年8月,重症医学科成为国家第二批专科医师规范化培训基地,并于2019年3月开始以内外科危重病医学专科两个方向招生.未来中国的重症医学建设发展更加需要我们明确学科发展规划,理清发展思路,坚持融合与创新,适应社会需求,在学科建设、人才培养、诊疗体制、科研创新和网络数据智能化应用等方面建立高效而规范的体制模式.尤其是在大力开展并促进重症医学专科医师规范化培训的同质化,加强后备人才储备;积极推动中国重症医学临床研究平台建设,支持并鼓励开展多中心临床研究;促进国内外重症医学领域多渠道交流,逐步扩大中国重症医学的国际影响力等方面作出新的贡献,以推动中国重症医学的可持续发展,使我们的学科站在现代医学的最前沿,为人类健康作出更大的贡献.

As early as August 1974,"organ failure resuscitation ward" for critically ill patients with cardiac, respiratory or renal failure had appeared as independent medical units in China. In 1980s, the discipline of critical care medicine had experienced a rapid development, shown its superiority in both daily health care and public health emergency, also its status in the academy of medicine. On September 4th, 1989, the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) accepted the Chinese Association of Integrative Medicine, Society of Critical Care Medicine (TCMWMCSCCM) as an official member. In November 1989, the former State Scientific and Technological Commission approved the establishment of Critical Care Medicine in Tianjin, the first journal in the very field in China, indicating that Chinese critical care medicine has been officially accepted by the international academia and its academic status has been determined. In September 1997, the Chinese Association of Pathophysiology organized the Chinese Society of Critical Care Medicine. In March 2005, the Chinese Medical Association organized the Chinese Society of Critical Care Medicine had found. In July 2009, Chinese Association of Critical Care Physicians had found under the Chinese Medical Doctor Association. In 2008, Critical Care Medicine had been defined as secondary clinical discipline (Subject code 320.58) by Standardization Administration of the People's Republic of China. In 2009, it was listed in the first clinical discipline (Code 28). In 2001, Chinese Society of Critical Care Medicine under the Chinese Association of Pathophysiology had officially joined the WFSICCM and the Asia Pacific Association of Critical Care Medicine (APACCM), and became a member in both councils. Between 2006 and 2010, Chinese Society of Critical Care Medicine under the Chinese Association of Pathophysiology had become the presidency and member in APACCM, WFSICCM and Global Sepsis Alliance (GSA), respectively. So far, there are a number of critical care physicians from China serve as a member in international academic organizations. In ESICM LIVES 2012, held in Lisbon, Portugal, the Chinese Society of Critical Care Medicine under the Chinese Association of Pathophysiology was invited on behalf of China and gave lectures, showing the elegant demeanor of Chinese scholars. Since 2013, the Annual Congress of Chinese Society of Critical Care Medicine has set up the China-USA Joint forum and China-Europe forum. In 2018, the Chinese Society of Critical Care Medicine started a series of "Belt and Road" academic activities, signed the cooperation agreement with 18 academic community of critical care medicine from respective countries or districts along the Belt and Road, and established a long-term relation of communication and cooperation, indicating that Chinese critical care medicine has intensively participated in international communication and integration. Year 2019 is the 40th year of Chinese construction and development in critical care medicine. Today, Chinese critical care medicine is taking off. It has developed rapidly on a brand-new level, advanced on the highway of professional and standardized development, achieved a series of development and won the praise of peers around the world. Since the establishment of Chinese Society of Critical Care Medicine in March 2005, the scale of annual congresses has expanded year by year, participants increased from mere 1?000 to more than 15?000, contributions increased from hundreds to thousands, exhibiting the prosperity of Chinese critical care medicine. Meanwhile, the society has published guideline series, technical specifications and academic yearbooks, implemented Chinese Critical Care Certified Course (5C training), carried out the continue education program and grassroot education activities, set up the "lifetime achievement award", etc., to promote continuous progress and development in Chinese critical care medicine. The Chinese Association of Critical Care Physicians has greatly contributed to the promotion in critical care specialist training, also push forward the progress. In August 2018, department of critical care medicine was selected in the second batch of standardized training bases for specialists, and began recruitment in both medical and surgical critical care medicine in March 2019. The future of Chinese critical care medicine requires us to make clear the developmental blueprint of the discipline, to persevere with integration and innovation, and to meet the needs of society. Efficient and normative systems are also required in the discipline construction, talent cultivation, diagnosis and treatment system, academic construction, and intelligent application of network data. Particularly, we should vigorously carry out and promote the homogenization of critical care specialist training for talent resources reservation. We should actively promote the establishment of clinical research platforms for critical care medicine, encourage and support multicenter clinical researches. We should promote multi-channel communication in the field at home and abroad, expand the international influence of Chinese critical care medicine step by step, to promote the sustainable development of Chinese critical care medicine, to explore further forefront of modern medicine, to promote greater contribution to human health.