CAJ | 학술논문

目的：探索社区医生提高和防治早期CKD的效果和如何减轻疾病对健康的危害，降低医疗费用。方法：对长宁区的周家侨、华阳、新华三家社区卫生服务中心的医生随机抽取90名医生，然后到长宁区各社区进行慢性肾脏病相关知识推广和培训，1年后进行第2次问卷调查。结果：（1）推广知晓情况：推广后的平均分数（80.44±8.74）分明显高于推广前的（64.04±12.89）分，且推广后各分数段人数均明显多于推广前，差异均有统计学意义（P<0.01）。（2）对疑似肾损害患者的处置措施：推广前尿检者20名（22.22%），肾功能检查者21名（23.33%），建议专科就诊者25名（27.78%），其他24名（26.67%）。推广后尿检者45名（50.00%），肾功能检查者36名（40.00%），建议专科就诊者4名（4.44%），其他5名（5.56%），推广后社区医生给予尿检、肾功能检查、建议专科就诊、其他等处置措施的人数均明显多于推广前，差异均有统计学意义（P<0.01）。（3）评估肾功能指标的选择：推广前选择血肌酐者77名（85.56%），尿素者8名（8.89%），内生肌酐清除率者3名（3.33%），估计肾小球滤过率者2名（2.22%）。推广后选择血肌酐者60名（66.67%），尿素者1名（1.11%），内生肌酐清除率者10名（11.11%），估计肾小球滤过率者19名（21.11%），推广后社区医生选择血肌酐、尿素、内生肌酐清除情况、估计肾小球滤过问题等评估指标的人数均明显多于推广前，差异均有统计学意义（P<0.01）。结论：通过此次推广对社区医生的慢性肾脏病知识有所提高，提供了与社区医生互相交流学习的机会。
목적：탐색사구의생제고화방치조기CKD적효과화여하감경질병대건강적위해，강저의료비용。방법：대장저구적주가교、화양、신화삼가사구위생복무중심적의생수궤추취90명의생，연후도장저구각사구진행만성신장병상관지식추엄화배훈，1년후진행제2차문권조사。결과：（1）추엄지효정황：추엄후적평균분수（80.44±8.74）분명현고우추엄전적（64.04±12.89）분，차추엄후각분수단인수균명현다우추엄전，차이균유통계학의의（P<0.01）。（2）대의사신손해환자적처치조시：추엄전뇨검자20명（22.22%），신공능검사자21명（23.33%），건의전과취진자25명（27.78%），기타24명（26.67%）。추엄후뇨검자45명（50.00%），신공능검사자36명（40.00%），건의전과취진자4명（4.44%），기타5명（5.56%），추엄후사구의생급여뇨검、신공능검사、건의전과취진、기타등처치조시적인수균명현다우추엄전，차이균유통계학의의（P<0.01）。（3）평고신공능지표적선택：추엄전선택혈기항자77명（85.56%），뇨소자8명（8.89%），내생기항청제솔자3명（3.33%），고계신소구려과솔자2명（2.22%）。추엄후선택혈기항자60명（66.67%），뇨소자1명（1.11%），내생기항청제솔자10명（11.11%），고계신소구려과솔자19명（21.11%），추엄후사구의생선택혈기항、뇨소、내생기항청제정황、고계신소구려과문제등평고지표적인수균명현다우추엄전，차이균유통계학의의（P<0.01）。결론：통과차차추엄대사구의생적만성신장병지식유소제고，제공료여사구의생호상교류학습적궤회。
Objective:To explore the effect of preventing and controlling early of chronic kidney disease(CKD), how to decrease the harm of disease and reduce medical costs by community doctors.Method:90 doctors in Community Health Centre of Zhoujiaqiao,Huayang and Xinhua in Changning district were randomly selected.The knowledge of CKD was popularized and trained in community in changing district by them and the second questionnaire surveys were conducted after 1 year.Result:(1)Promote awareness:the average score after promotion was(80.44±8.74)score,it was significantly higher than(64.04±12.89)score before promotion,and the number of each grade score after promotion were significantly more than before promotion,the differences were statistically significant(P<0.01).(2)The disposal measures in patients with suspected renal damage:before promotion,20 patients(22.22%)with urine analysis,21 patients(23.33%)with renal function tests,25 patients(27.78%)with specialist diagnostic and 24(26.67%)other patients.After promotion,45 patients(50.00%)with urine analysis,36 patients(40.00%)with renal function tests, 4 patients(4.44%)with specialist diagnostic and 5(5.56%)other patients.After promotion,the number of patients with urine analysis,renal function tests,specialist diagnostic and other were significantly more than before promotion, the differences were statistically significant(P<0.01).(3)Estimation of renal function index:before promotion, 77 patients(85.56%)with serum creatinine,8 patients(8.89%)with urea,3 patients(3.33%)with endogenous creatinine clearance and 2 patients(2.22%)with estimation of glomerular filtration rate.After promotion,60 patients (66.67%)with serum creatinine,1 patient(1.11%)with urea,10 patients(11.11%)with endogenous creatinine clearance,19 patients(21.11%)with estimation of glomerular filtration rate.After promotion,the number of selection of serum creatinine,urea,endogenous creatinine clearance,estimation of glomerular filtration rate were significantly more than before promotion,the differences were statistically significant(P<0.01).Conclusion:The promotion can improve the knowledge of the chronic kidney disease in community doctors,provide mutual exchange of learning opportunities with community doctors.