摘要
背景世界上很多外科手术是在发展中国家进行的。为了改善急症患者和危重患者的生存率，必须确定发展中国家麻醉实施存在的基本问题和麻醉面临的需求。本次调查研究者评估了目前赞比亚共和国麻醉以及相关学科（包括危重症医学、急诊医学以及疼痛治疗）的现状。方法向在赞比亚共和国卫生部注册的87所可行大或小型外科手术的医院发放问卷，问卷包括111个问题，分为5组，分别涉及：医院总体信息、麻醉、重症监护、急诊医学及疼痛治疗。结果对其中68所医院的问卷进行统计学分析（78％）。手术种类中最常见的是妇产科、腹部外科手术。氯胺酮分离麻醉是最常用的全身麻醉方法（50％）。全身麻醉患者中10％进行气管插管，大部分（78％）医院麻醉实施由非注册医师完成。68所医院中只有5所（7％）回信称配备重症监护室，共有29个床位服务整个国家。麻醉医师基本不参与急诊工作和疼痛治疗。结论赞比亚共和国的麻醉医学极不发达，缺乏医疗相关资源。
BACKGROUND： Many surgical interventions worldwide are performed in developing countries. To improve survival of acutely and critically ill patients in these countries, basic problems and demands of anesthesia care need to be identified. Using this survey, we evaluated the current status of anesthesia and its allied disciplines （ intensive care medicine, emergency medicine, and pain therapy） in the Republic of Zambia. METHODS： Questionnaires were sent to 87 hospitals registered at the Zambian Ministry of Health as performing minor or major surgery. The questionnaire consisted of 111 questions grouped into five sections： general hospital information, anesthesia, intensive care, emergency medicine, and pain therapy. RESULTS： Sixty-eight questionnaires could be statistically evaluated （ 78% ）. The most common operations were obstetric/gynecological and abdominal surgical procedures. Dissociative ketamine anesthesia was the technique most often used for general anesthesia （50%）. Endotracheal intubation was performed in 10% of patients undergoing general anesthesia. In most hospitals （ 78% ）, anesthesia was administered by nonphysicians. Only 5 of 68 hospitals （ 7% ） reported having an intensive care unit, with 29 beds to serve the entire country. Anesthesiologists play almost no role in emergency medicine and pain therapy. CONCLUSIONS： Anesthesia in the Republic of Zambia is a highly under-developed and under-resourced medical specialty.
出处
《麻醉与镇痛》
2009年第2期93-100,共8页
Anesthesia & Analgesia
