四川省基层医疗卫生服务机构开展宫颈癌和乳腺癌筛查能力的调查  

Abilities of Primary Medical Services to Screen Cervical and Breast Cancers in Sichuan Province

作　　者：杨非[1,2] 黄源[1] 应桂英[3] 李佳圆[1] 甘华平[3] 力晓蓉[3] 齐亚娜[1] 

机构地区：[1]四川大学华西公共卫生学院,四川省成都市610041 [2]成都市疾病预防控制中心 [3]四川省卫生信息中心

出　　处：《中国全科医学》2014年第18期2118-2122,共5页Chinese General Practice

基　　金：四川省卫生厅科学研究基金(080321,100361);成都市科技局科技支撑项目(11PPYB002SF-289)

摘　　要：背景随着宫颈癌和乳腺癌发病率的逐年升高,原国家卫生部在全国开展了宫颈癌和乳腺癌筛查的试点工作。目的了解四川省基层医疗卫生服务机构开展宫颈癌和乳腺癌筛查的能力。方法 2011年6月—2012年6月,通过查阅文献、专题小组讨论和德尔菲法获得调查指标;通过收集既往资料、现场观察、电话访问获取四川省71家基层医疗卫生服务机构的相关信息,对基层医疗卫生服务机构的基本情况及开展宫颈癌、乳腺癌筛查的人力资源、仪器设备、技术能力进行调查,并比较不同经济水平地区和不同地貌地区机构的差异。结果高国内生产总值(GDP)组较低GDP组业务用房面积大(P<0.05),平坝组床位数较丘陵组、山区组多(P<0.05);高GDP组年门急诊诊疗人次数较低GDP组多(P<0.05),不同地貌地区年门急诊诊疗人次数间差异无统计学意义(P>0.05)。高GDP组在岗工作人员、卫生技术人员、大专及以上学历人员、执业医师、注册护士、中/西医药师(士)、检验和影像技师(士)均多于低GDP组,平坝组的上述人员多于丘陵组和山区组(P<0.05)。71家机构中,67家配置有妇科检查床及器械,9家配置了乳腺高频超声,3家配置了细胞学检测器材,3家配置了近红外线,1家配置了阴道镜,各机构均未配置人乳头瘤病毒(HPV)-DNA和钼靶X线检测设备;10家机构开展过宫颈癌筛查,5家机构开展过乳腺癌筛查。共39家机构建立了居民健康档案,高GDP组居民健康档案建立率高于低GDP组,平坝组高于丘陵组和山区组(P<0.05)。结论目前四川省基层医疗卫生服务机构开展宫颈癌和乳腺癌筛查的能力较弱,只能够承担起宫颈癌和乳腺癌筛查项目中组织动员和初步筛查的任务,建议通过合理提高和配置卫生人力资源,加强基层医疗卫生服务机构筛查宫颈癌和乳腺癌的能力。Background With the increase of cervical and breast cancers,China＇s Ministry of Health had launched a nationwide pilot screening for women. Objectives To know the abilities of primary medical services to screen cervical and breast cancers in Sichuan Province. Methods From June 2011 to June 2012,the survey indexes were obtained through literature consulting,group discuss and by Delphi methods. The relevant information of 71 primary medical services were acquired by collecting past data,field observation,telephone interview. The basic information,human resources,instruments and equipments, technical capacity of primary medical services were investigated,and the differences were compared between the institutions in areas at different economic levels and in those with different landforms. Results The area for working rooms was larger in high GDP group than in low GDP group,and larger in flatland group than in groups of hill and mountain（P〈0. 05）. The annual mean person/time at clinics were more in high GDP group than low GDP group（P〈0. 05）,and there was no significant difference between institutions in areas with different landforms（P〉0. 05）. The number of on-duty staff,health workers,those with educational levels of junior college or higher,certificated physicians,registered nurses,pharmacists,technicians of check and image was bigger in high GDP group than in low GDP group,bigger in flatland group than in groups of hill and mountain（ P〈0. 05）. In 71 investigated institutions,67 had gynecological examining tables and instruments,9 had breast high-frequency ultrasound,3 had cytological checkout equipments,3 had near infrared ray,1 had colposcope,all had not HPV-DNA or tar-get X ray equipments;10 carried out cervical cancer screening,5 had breast cancer screening. 39 had established resident health records,the rate of health records were higher in high GDP group than in low GDP group,higher in flatland group than in groups of hill and mountain（P〈0. 05）. Conclusion At present,the ability

关 键 词：卫生系统机构 宫颈肿瘤 乳腺肿瘤 筛查 

分 类 号：R19[医药卫生—卫生事业管理]