北京市某区各级医疗机构慢性乙型肝炎诊疗现状调查  

Diagnosis and Treatment of Chronic Hepatitis B: A Status Survey of Different Levels of Medical Establishments in A District of Beijing

作　　者：马丽霞[1] 刘晓慧[1] 郭海清[1] 韦新焕[1] 张晶[1] 段钟平[1] 

机构地区：[1]首都医科大学附属北京佑安医院,北京市100069

出　　处：《中国全科医学》2013年第32期3833-3836,共4页Chinese General Practice

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项资助项目(2012ZX10002004-006);北京市朝阳区艾滋病和病毒性肝炎等重大传染病综合防治示范区建设研究资助项目(2012ZX10004904)

摘　　要：目的了解北京市某区各级医疗机构慢性乙型肝炎(乙肝)诊疗现状,为制定有效的乙肝防控政策与措施提供参考。方法分别抽取该区流动人口400名、肝病患者280名、肝病医生64名,采用不记名问卷调查法,用自行设计的调查问卷进行调查,了解其乙肝相关知识知晓情况(不同调查对象调查内容与重点不同)及各级医疗机构乙肝诊疗能力。结果 400名流动人口中,知晓乙肝症状者137名(34.3%),知晓乙肝传播途径者146名(36.5%),知晓乙肝加重诱因者166名(41.5%),知晓乙肝向肝硬化或肝癌转化率者205名(51.2%),知晓接种乙肝疫苗者112名(28.0%)。280名肝病患者中,知晓乙肝症状者258名(92.1%),知晓乙肝传播途径者253名(90.3%),知晓肝硬化病因者279名(99.6%),知晓肝病加重因素者256名(91.4%);门诊定期复查者(至少每年1次)177名(63.3%)。64名肝病医生中,知晓乙肝诊断知识者64名(100%),知晓大三阳定义者61名(95.3%),知晓干扰素适应证者61名(95.3%),知晓干扰素不良反应者48名(75.0%),知晓母婴阻断者61名(95.3%)。该区42家医院中,二级及三级医院肝病专科医生平均为(3±1)名;一级医院无肝病专科医生,乙肝相关检查项目不全,且未配备抗病毒药物。结论该区流动人口肝病相关知识知晓率低,肝病患者乙肝知识及健康行为不能知行合一,肝病医生诊疗能力有待提高。应加强该区流动人口乙肝相关知识的科普宣传和肝病患者的健康教育,加强肝病医生乙肝相关知识的培训,从人力、物力资源配置上提高各级医疗机构的乙肝诊疗水平。Objective To probe the knowledge of status of diagnosis and treatment of chronic hepatitis B （HB） in different levels of medical establishments in a district of Beijing, to provide a basis for formulating policy and measures for effec- tive HB control. Methods Totally 400 migrating people, 280 patients with liver disease, 64 physicians in this district were en- rolled in this study. Self - designed questionnaire was used to understand their HB - related knowledge and diagnosis, treatment ability of different levels of medical establishments. Results In the 400 migrating people, 137 had the knowledge of HB symp- toms （34. 3% ）, 146 knew the route of transmission of HB （36. 5% ）, 166 knew the incentives of HB aggravation （41.5%）, 205 knew the conversion rate from HB to cirrhosis or liver cancer （51.2%）, 112 knew HB vaccine （28. 0% ）. In the 280 pa- tients with liver disease, 258 knew HB symptoms （92. 1% ）, 253 knew the route of transmission of HB （90. 3% ）, 279 knew the cause of cirrhosis （99. 6% ）, 256 knew the cause of liver disease aggravation （91.4%） ; 177 had regular reexaminations （63.3%）. In the 64 physicians, 64 knew knowledge of HB diagnosis （ 100% ）, 61 knew HBsAg definition （95.3%）, 61 knew indications of interferon （95.3%）, 48 knew adverse reactions of interferon （75.0%）, 61 knew interdiction of maternal - neonatal transmission （95.3%）. In the 42 hospitals, there were （3 ~ 1 ） liver disease specialists averagely in second - class and tertiary hospitals, there was no in first - class hospitals, in which HB related inspection items were incomplete and not e- quipped with antiviral drugs. Conclusion The awareness rate of HB knowledge is low among migrating population, the patients with liver disease could not put their knowledge into practice, and the capability of the doctors in diagnosing and treating HB is quite limited. Therefore, popular science propaganda of liB -related knowledge and health education should be strengthened in migrat

关 键 词：肝炎 乙型 慢性 认知 诊断 治疗 横断面研究 

分 类 号：R575.1[医药卫生—消化系统]