中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
27期
3339-3342,3343
,共5页
郭蓉%罗海燕%曹建设%蔡姿丽%杨龙贵
郭蓉%囉海燕%曹建設%蔡姿麗%楊龍貴
곽용%라해연%조건설%채자려%양룡귀
腹泻病%液体疗法%乡镇卫生院%社区卫生服务%数据收集
腹瀉病%液體療法%鄉鎮衛生院%社區衛生服務%數據收集
복사병%액체요법%향진위생원%사구위생복무%수거수집
Diarrhea%Fluid therapy%Health centers in villages and towns%Community health services%Data collection
目的：调查乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解程度并分析其影响因素，为进一步制定适且技术的培训方案提供参考依据。方法选取2012年9—11月参加湖南省儿童医院对湖南省14个地州市进行的儿科急诊适宜技术推广培训的1315家乡镇卫生院和1480名基层医务人员为调查对象。采用乡镇卫生院现况调查表、测试卷和个人信息表调查乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解情况，并分析其影响因素。结果共有1217家（92.5%）乡镇卫生院提交了完整合格的乡镇卫生院现况调查表。乡镇卫生院2011年排在前3位的儿科常见疾病是肺炎、腹泻、上呼吸道感染；744家（61.1%）乡镇卫生院有医务人员近3年参加过儿科相关知识的培训；971家（79.8%）乡镇卫生院认为开展小儿腹泻病液体疗法相关知识的培训适宜。共发放测试卷1267份，收回1173份，剔除个人信息填写不完整的测试卷，共有1095份有效测试卷，有效回收率为86.4%。基层医务人员对小儿腹泻病相关知识腹泻类型、1/2张液体的配制、脱水合并低血糖时补25%葡萄糖（ GS）的用量的了解率>50.0%，而对其他知识点的了解率却<50.0%。1095名基层医务人员中，仅有376名（34.3%）对小儿腹泻病液体疗法相关知识有所了解。不同执业类别、地区的基层医务人员对小儿腹泻病液体疗法相关知识了解率比较，差异有统计学意义（P<0.05）。多因素条件Logistic回归分析结果显示，从执业类别来看，以其他执业类别的基层医务人员为参照，儿科执业医师对小儿腹泻病液体疗法相关知识了解率高于其他执业类别（ P<0.05）；从不同地区来看，以湘南地区基层医务人员为参照，环长株潭城市群、大湘西地区基层医务人员对小儿腹泻病液体疗法相关知识了解率高于湘南地区（P<0.05）。结论乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解程度较低，了解水平参差不齐，考虑与乡镇卫生院儿科专科医生少、缺乏对小儿腹泻病的系统学习和知识更新有关，急需小儿腹泻病液体疗法相关知识的培训。
目的：調查鄉鎮衛生院基層醫務人員對小兒腹瀉病液體療法相關知識的瞭解程度併分析其影響因素，為進一步製定適且技術的培訓方案提供參攷依據。方法選取2012年9—11月參加湖南省兒童醫院對湖南省14箇地州市進行的兒科急診適宜技術推廣培訓的1315傢鄉鎮衛生院和1480名基層醫務人員為調查對象。採用鄉鎮衛生院現況調查錶、測試捲和箇人信息錶調查鄉鎮衛生院基層醫務人員對小兒腹瀉病液體療法相關知識的瞭解情況，併分析其影響因素。結果共有1217傢（92.5%）鄉鎮衛生院提交瞭完整閤格的鄉鎮衛生院現況調查錶。鄉鎮衛生院2011年排在前3位的兒科常見疾病是肺炎、腹瀉、上呼吸道感染；744傢（61.1%）鄉鎮衛生院有醫務人員近3年參加過兒科相關知識的培訓；971傢（79.8%）鄉鎮衛生院認為開展小兒腹瀉病液體療法相關知識的培訓適宜。共髮放測試捲1267份，收迴1173份，剔除箇人信息填寫不完整的測試捲，共有1095份有效測試捲，有效迴收率為86.4%。基層醫務人員對小兒腹瀉病相關知識腹瀉類型、1/2張液體的配製、脫水閤併低血糖時補25%葡萄糖（ GS）的用量的瞭解率>50.0%，而對其他知識點的瞭解率卻<50.0%。1095名基層醫務人員中，僅有376名（34.3%）對小兒腹瀉病液體療法相關知識有所瞭解。不同執業類彆、地區的基層醫務人員對小兒腹瀉病液體療法相關知識瞭解率比較，差異有統計學意義（P<0.05）。多因素條件Logistic迴歸分析結果顯示，從執業類彆來看，以其他執業類彆的基層醫務人員為參照，兒科執業醫師對小兒腹瀉病液體療法相關知識瞭解率高于其他執業類彆（ P<0.05）；從不同地區來看，以湘南地區基層醫務人員為參照，環長株潭城市群、大湘西地區基層醫務人員對小兒腹瀉病液體療法相關知識瞭解率高于湘南地區（P<0.05）。結論鄉鎮衛生院基層醫務人員對小兒腹瀉病液體療法相關知識的瞭解程度較低，瞭解水平參差不齊，攷慮與鄉鎮衛生院兒科專科醫生少、缺乏對小兒腹瀉病的繫統學習和知識更新有關，急需小兒腹瀉病液體療法相關知識的培訓。
목적：조사향진위생원기층의무인원대소인복사병액체요법상관지식적료해정도병분석기영향인소，위진일보제정괄차기술적배훈방안제공삼고의거。방법선취2012년9—11월삼가호남성인동의원대호남성14개지주시진행적인과급진괄의기술추엄배훈적1315가향진위생원화1480명기층의무인원위조사대상。채용향진위생원현황조사표、측시권화개인신식표조사향진위생원기층의무인원대소인복사병액체요법상관지식적료해정황，병분석기영향인소。결과공유1217가（92.5%）향진위생원제교료완정합격적향진위생원현황조사표。향진위생원2011년배재전3위적인과상견질병시폐염、복사、상호흡도감염；744가（61.1%）향진위생원유의무인원근3년삼가과인과상관지식적배훈；971가（79.8%）향진위생원인위개전소인복사병액체요법상관지식적배훈괄의。공발방측시권1267빈，수회1173빈，척제개인신식전사불완정적측시권，공유1095빈유효측시권，유효회수솔위86.4%。기층의무인원대소인복사병상관지식복사류형、1/2장액체적배제、탈수합병저혈당시보25%포도당（ GS）적용량적료해솔>50.0%，이대기타지식점적료해솔각<50.0%。1095명기층의무인원중，부유376명（34.3%）대소인복사병액체요법상관지식유소료해。불동집업유별、지구적기층의무인원대소인복사병액체요법상관지식료해솔비교，차이유통계학의의（P<0.05）。다인소조건Logistic회귀분석결과현시，종집업유별래간，이기타집업유별적기층의무인원위삼조，인과집업의사대소인복사병액체요법상관지식료해솔고우기타집업유별（ P<0.05）；종불동지구래간，이상남지구기층의무인원위삼조，배장주담성시군、대상서지구기층의무인원대소인복사병액체요법상관지식료해솔고우상남지구（P<0.05）。결론향진위생원기층의무인원대소인복사병액체요법상관지식적료해정도교저，료해수평삼차불제，고필여향진위생원인과전과의생소、결핍대소인복사병적계통학습화지식경신유관，급수소인복사병액체요법상관지식적배훈。
Objective To evaluate the knowing rate of relevant knowledge of fluid therapy on children with diarrhea by medical staff in the health centers in villages and towns and investigate its influencing factors,in order to provide references for the further formulation of training scheme. Methods From September to November 2012 , we enrolled 1 315 health centers in villages and towns and 1 480 grassroots medical staff in 14 autonomous prefectures and cities of Hunan Province that received the training of appropriate skills in pediatric emergency treatment organized by Hunan Children's Hospital. A questionnaire and a test paper about the status of health centers in villages and towns and a questionnaire about individual information were used to investigate the knowing rate of relevant knowledge of fluid therapy on children with diarrhea by medical staff in the health centers in villages and towns,and the influencing factors were explored. Results A total of 1 217(92. 5%)health centers in villages and towns submitted complete and qualified questionnaires about the status of health centers in villages and towns. In 2011,the first three common diseases with the largest prevalence in the health centers in villages and towns were pneumonia,diarrhea and upper respiratory infection;744(61. 1%)health centers in villages and towns had medical staff who had participated in relevant training about pediatric knowledge;971(79. 8%)health centers considered the training of relevant knowledge of fluid therapy on children with diarrhea is appropriate. A total of 1 267 test papers were distributed,and 1 173 papers were recollected. After the exclusion of incomplete test papers,1 095 effective test papers were returned with an effective returning rate of 86. 4%. The knowing rate of diarrhea type, the preparation of 1/2 isotonic liquid and the dosage of 25% glucose sugar in the case of dehydration complicated with hypoglycemia was more than 50. 0%. The knowing rates of other knowledge were all lower than 50. 0%. Among 1 095 grassroots medical staff,only 376(34. 3%)knew about the fluid therapy on children with diarrhea. The knowing rate of relevant knowledge of the fluid therapy varied significantly with types of job and different regions( P <0. 05 ) . Multiple conditional Logistic regression analysis showed that pediatric medical practitioners had higher(P<0. 05)knowing rate of fluid therapy on children with diarrhea than grassroots medical staff of other types of job;the grassroots medical staff in Changsha-Zhuzhou-Xiangtan city group and western Hunan Province had higher( P<0. 05 )knowing rate of fluid therapy on children with diarrhea than the grassroots medical staff in south Hunan Province. Conclusion Grassroots medical staff in the health centers in villages and towns have poor mastery of relevant knowledge of fluid therapy on children with diarrhea,and the mastery degree varies significantly from people to people. Due to a lack of professional pediatric doctors,a lack of systematic learning of diarrhea in children and the update of relevant knowledge, there is an urgent need for the training of relevant knowledge of fluid therapy on children with diarrhea.
