大型综合医院在突发公共卫生事件中平战结合改建实证与反思  

Experimental study and reflection on peacetime and wartime reconstruction of large general hospitals in public health emergencies

作　　者：龚瑞娥[1] 曾烂漫[1] 李春辉[1] 张乐[2] 吴静[2] 陈子华[3] 雷光华[4,5] 黄勋 GONG Rui’e;ZENG Lanman;LI Chunhui;ZHANG Le;WU Jing;CHEN Zihua;LEI Guanghua;HUANG Xun(Department of Hospital Infection Control Center,Xiangya Hospital,Changsha 410008;Department of Medical Administration Division,Xiangya Hospital,Changsha 410008;Department of General Surgery,Xiangya Hospital,Changsha 410008;Department of Orthopaedics,Xiangya Hospital,Changsha 410008;National Center for Clinical Medicine of Geriatric Diseases,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院感染控制中心,长沙410008 [2]中南大学湘雅医院医务部,长沙410008 [3]中南大学湘雅医院普外科,长沙410008 [4]中南大学湘雅医院骨科,长沙410008 [5]国家老年疾病临床医学研究中心,长沙410008

出　　处：《中南大学学报（医学版）》2020年第5期489-494,共6页Journal of Central South University ：Medical Science

基　　金：中南大学新型冠状病毒感染的肺炎防控首批应急项目(160260003)。

摘　　要：为应对2019冠状病毒病的救治,中南大学湘雅医院根据现有医疗建筑布局分析适合改建隔离病房的条件并进行合理改造,分区收治患者,改建基本符合隔离病房要求,实现相应的分区及人流、物流分隔。但区域的分隔是以占用医疗用房为代价实现的,凸显综合医院建筑布局在应对突发公共卫生事件的不足。建议综合医院应有忧患意识,在新建、改建和扩建时应充分考虑不同建筑类型的特点、缺陷及医院的功能要求,不但要满足医院日常发展的需要,还需要考虑应对突发公共卫生事件中可能遇到的功能需求。可采取合理布局,如通道及楼层间设类似防火墙装置,在不同区域安装可活动的闸门,平时作为普通病房收治患者,在应急情况下可以拉下闸门,隔断相应区域形成独立空间。这样既可规避常规按经空气、飞沫传播疾病设置病房而平时使用率低的问题,最大限度地发挥医疗场地的效能,又可避免突发公共卫生事件发生时临时改建病房而慌忙应对的问题。To propose the architectural layout for the big general hospital in the face of public health emergencies, we analyzed the conditions, methods, problems and countermeasures for the reconstruction of the isolation ward from the existing medical building layout of a general hospital. The affected areas met the requirements of isolation ward in the reconstruction,and realized the corresponding partition and separation of people. But the cost of occupying the medical room should be concerned. General hospital should be alerted to potential risks of public health emergencies. The characteristics of different construction types, defects, and the function of the hospital should be considered in the construction,rebuilding, and expansion of the hospital, which shouldnot only meet the needs of the development of the hospital daily usage but also consider dealing with emergent public health events. We can adopt the reasonable layout, including setting up a firewall-like device between the channel and the floor, an ordinary ward at ordinary times, and an independent space for emergency by pulling down the gate. This strategy can not only avoid the problem of low utilization rate of the space occupied by the corresponding area in the ward for diseases spread by air and droplets, maximizing the efficiency of the medical site, but also avoid the problem of emergency response to the temporary reconstruction.

关 键 词：突发公共卫生事件 2019冠状病毒病 综合医院 建筑布局 反思 

分 类 号：R197.32[医药卫生—卫生事业管理]