上海市郊两社区慢性阻塞性肺疾病防治状况调查  

An investigation on prevention and treatment of chronic obstructive pulmonary disease at two community health service centers in urban and suburban Sbanghai

作　　者：徐迅[1] 李凡[1] 张学民[1] 朱王汇[1] 傅欢英 沈朝英 陆元英 庄棋军 殷建峰 李苏华[1] 殷为文[1] 周美华[1] 陈小丽[1] 蔡映云[4] 

机构地区：[1]上海交通大学附属第一人民医院松江分院呼吸科,201600 [2]上海市小昆山社区卫生服务中心 [3]上海市新浜社区卫生服务中心 [4]复旦大学附属中山医院呼吸病研究所

出　　处：《中华全科医师杂志》2009年第9期614-616,共3页Chinese Journal of General Practitioners

基　　金：上海市卫生局课题（2007169）

摘　　要：目的了解上海市市郊城乡结合部两个社区卫生服务中心慢性阻塞性肺疾病（CODP）防治现状，为CODP社区防治提供基本数据。方法对上海市松江区小昆山、新浜两个乡镇的社区卫生服务中心服务区域内，40岁以上慢性咳嗽、气喘711例患者进行肺功能检查，确诊COPD132例，采用调查问卷进行面对面的防治现状调查。结果依据肺功能判断为COPDⅠ级的患者有6例，Ⅱ级29例，Ⅲ级58例，Ⅳ级39例。患者中未吸烟者68例，占总人数的51．5％；曾经吸烟但已戒烟者40例，占30．3％，现仍在吸烟者24例，占18．2％。吸烟者中，COPDⅡ级5例，Ⅲ级12例，Ⅳ级7例。所有患者既往均未进行肺功能检查。除Ⅰ级外，1年中Ⅱ、Ⅲ、Ⅳ级患者门诊就诊数仅为46例，占总人数126例的36．5％，住院病例为35例，占总人数126例的27．8％。1年中COPD患者服用过茶碱类药物16例（16／132，占12．1％），服过B：受体激动剂24例（占18．2％），吸入支气管扩张剂仅9例（占6．8％），吸人激素的仅3例（2．3％）。有26例COPD（占19．7％）患者服用过一些成分不明、无国家药物生产批号的非法药物。在97例Ⅲ、Ⅳ级COPD患者中，家庭氧疗的仅为1例。结论社区COPD患者诊断治疗严重不足，需要规范。Objective The purpose of this study was to investigate and analyze current status of prevention and treatment for chronic obstructive pulmonary disease （COPD） at two community health service centers in urban and suburban Shanghai. Methods Among 711 patients with chronic cough and shortness of breath aged more than 40 years who visited Xiaokunshan and Xinbang community health service centers in Songjiang district of Shanghai, 132 were diagnosed as COPD and a face-to-face interview was conducted for all of them with questionnaires to understand current status of community prevention and treatment of COPD. Results Among 132 COPD patients, six （4. 5% ） were classified as stage Ⅰ, 29 （22. 1% ） as stage Ⅱ, 58 （43.9%） as stage Ⅲ and 39 （29. 5% ） as stage Ⅳ, respectively, according to their pulmonary function. Sixty-eight （51.5%） of them never smoked, 40 （30. 3% ） were past smokers but now quitters and 24 （18.2%） were current smokers, respectively. All the 126 smoking patients of COPD, including five at stage Ⅱ 12 at stage Ⅲ and seven at stage Ⅲ, never underwent pulmonary function tests, and only 46 （36. 5% ） of those at stages Ⅱ, Ⅲ and Ⅳ visited out-patient clinics over the past year and 35 （27. 8% ） were hospitalized. Sixteen of them （12. 1%） were once orally administered with theophyllines, 24 （18.2%） with β2 receptor agonists, nine with （6. 8% ） inhaled bronchedilators, only three （2. 3% ） with inhaled corticosteroid hormones, respectively, over the past year. Twenty-six （19. 7% ） patients with COPD took illicit drugs of unknown ingredients and without production batches licensed by the State Food and Drug Administration （SFDA）. Among 97 COPD patients at stages Ⅲ and Ⅳ, only one received long-term home oxygen therapy. Conclusion Management of COPD patients at community level was inadequate and should be standardized.

关 键 词：肺疾病 慢性阻塞性 社区卫生中心 问卷调查 

分 类 号：R563.9[医药卫生—呼吸系统]