痛风和高尿酸血症的综合防治技术在基层医院的推广应用  

Popularization of gout and hyperuricemia prevention and treatment in primary hospitals

作　　者：孙佳颖 陈剑 孙培芳 王鑫[1] 岳丽霞 汪佳佳 俞钟明[1] SUN Jiaying;CHEN Jian;SUN Peifang(Department of Rheumatology,Shaoxing People’s Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)风湿免疫科,浙江绍兴312000 [2]绍兴市越城区东浦街道社区卫生服务中心内科 [3]绍兴市越城区灵芝街道社区卫生服务中心内科

出　　处：《全科医学临床与教育》2020年第8期723-727,共5页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划项目适宜技术(2018237556)。

摘　　要：目的探讨痛风和高尿酸血症的综合防治技术在绍兴地区基层医院中的推广应用效果。方法选择三家社区服务中心进行痛风和高尿酸血症的综合防治技术推广应用,对125位基层医院医师在推广前及推广后进行相关知识的问卷考核。在推广应用的社区服务中心选择90例痛风急性发作患者为观察组,在未推广应用的社区服务中心选择90例痛风急性发作患者为对照组,观察激素+抗生素使用比例、小剂量秋水仙碱使用比例、痛风急性期加降尿酸药物比例,1月后问卷调查或电话随访患者相关知识的知晓率、随访率,进行统计分析。结果基层医师的痛风和高尿酸血症相关知识较缺乏,推广后明显改善。痛风急性发作时推广社区的基层医师激素+抗生素使用比例较未推广社区的明显减少,小剂量秋水仙碱使用比例明显增加,痛风急性期加降尿酸药物比例明显减少(χ^2分别=11.93、19.74、33.76,P均<0.05)。推广后社区的患者较未推广社区的急性患者对痛风和高尿酸血症相关知识了解增加,患者1月内随访率(41.11%vs 15.56%)明显增加,差异有统计学意义(χ^2=14.47,P<0.05)。结论痛风和高尿酸血症的综合防治技术在基层医院中有较高的应用价值,可以明显提高基层医师和患者的痛风和高尿酸血症相关知识,提高痛风和高尿酸血症规范诊治。Objective To explore the application effect of gout and hyperuricemia prevention and treatment methods in primary hospitals in Shaoxing.Method Three community service centers were selected for the popularization of gout and hyperuricemia prevention and treatment.Totally 125 doctors from these three community service centers conducted a questionnaire before and after the training to evaluate the promotion effect.Ninety patients from the community service center with gout and hyperuricemia prevention and treatment methods were selected as the observation group,and 90 patients from the other community service center without gout and hyperuricemia prevention and treatment methods were selected as the control group.The proportion of glucocorticoid with antibiotics,small dose of colchicine,and urate-lowering drugs in the acute stage of gout were mainly observed.The knowledge awareness rate and follow-up rate were caculated by questionnaire survey or telephone after 1 month.Results The doctors from primary hospitals were lack of the knowledge of gout and hyperuricemia,and they significantly improved the ralative knowledges after popularization.The proportion of glucocorticoid with antibiotics was significantly decresing,while the proportion of small dose of colchicine was significantly incresing,and the proportion of urate-lowering drugs in the acute stage of gout was significantly decresing(χ^2=11.93,19.74,33.76,P<0.05).The knowledge of gout and hyperuricemia prevention and treatment in observation group was significantly deeper than the control group,and the follow-up rate within 1 month of observation group was significantly higher than that of control group(χ^2=14.47,P<0.05).Co⁃nclusion The comprehensive prevention and treatment of gout and hyperuricemia has a high application value in primary hospitals,which can significantly improve the knowledge of gout and hyperuricemia of doctors and patients,and standardize the diagnosis and treatment of gout and hyperuricemia.

关 键 词：痛风 高尿酸血症 综合防治 基层医院 

分 类 号：R589.7[医药卫生—内分泌]