Urgent revision required of NICE guidance relating to prevention of spread of vCJD through neurosurgical instruments
Urgent revision required of NICE guidance relating to prevention of spread of vCJD through neurosurgical instruments
复制标题
需要紧急修订与通过神经外科器械预防 vCJD 传播有关的 NICE 指南
DOI：
10.3109/02688697.2014.901709
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发表时间：
2014
影响因子：
1.1
通讯作者：
K. George
中科院分区：
文献类型：
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作者：
K. George
2006年，NICE发布了关于通过受污染的手术器械预防vCJD的指南。这是为了保护1997年后出生的患者，这些患者通过食物链食用受疯牛病污染的牛肉，不会有任何患上vCJD的风险。许多成人神经外科单位直到2013年才太注意这一点，当时他们突然面对这些现在16岁的孩子，他们住进了成人神经外科服务，而不是儿科。NICE指南要求大多数1997年后出生的患者使用与之前出生的患者不同的一套神经外科器械进行手术。事实证明，这是一个巨大的财务和后勤挑战，也是一个临床风险，因为人们的注意力正被转移到寻找正确的试剂盒上，而它本应用于拯救生命。现在很明显，2013年NICE担心的风险可能被夸大了，因为VCJD导致的死亡人数远远低于NICE担心的死亡人数。全世界只有5例CJD通过受污染的神经外科器械传播，最后一例发生在1976年。目前还没有因使用受污染的神经外科器械而导致vCJD传播的病例。鉴于这些情况，NICE应该紧急重新审视这一指导方针。
Abstract In 2006, NICE brought out guidance relating to prevention of vCJD through contaminated surgical instruments. This was with the aim of protecting patients born after 1997 who did not have any risk of developing vCJD through eating beef contaminated with BSE through the food chain. Many adult neurosurgical units did not pay much attention to this until 2013 when they were suddenly faced with these children who were now 16 and being admitted to the adult neurosurgical service rather than pediatric. The NICE guidance requires that most patients born after 1997 be operated on using a separate set of neurosurgical instruments than those born before this. This is proving to be a huge financial, as well as logistical, challenge and also a clinical risk as attention is being diverted to searching for the right kit when it should be spent on saving lives. It is now clear in 2013 that the risks that NICE feared were perhaps overstated as there is nowhere near the number of deaths from vCJD that NICE had feared would happen. Worldwide there have been only five cases whereby CJD was transmitted through contaminated neurosurgical instruments and the last case was in 1976. There have been no cases of vCJD transmission attributed to use of contaminated neurosurgical instruments. NICE should revisit this guidance urgently in view of these circumstances.