浙南地区基层医疗机构全科医生急救能力的问卷调查  

Survey on the first-aid capability of primary general practitioners in southern Zhejiang province

作　　者：侯若南 索朗德吉 周小明 周炜 雷李美 张敏武 徐喜益 翁杰[1] 吴丽萍 王志翊[1] 陈大庆[1] Hou Ruonan;Dekyi Sonam;Zhou Xiaoming;Zhou Wei;Lei Limei;Zhang Minwu;Xu Xiyi;Weng Jie;Wu Liping;Wang Zhiyi;Chen Daqing(Department of General Practice,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Gudui Township Health Center of Cuomei County,Shannan 856900,China;Department of General Practice,Taizhou Hospital,Taizhou 318000,China;Department of General Practice,Lishui People′s Hospital,Lishui 323000,China;Yaoxi Community Health Service Center,Wenzhou 325024,China;Yantou Health Center,Yongjia County,Wenzhou 325100,China;Qianku Health Center of Cangnan County,Wenzhou 325804,China)

机构地区：[1]温州医科大学附属第二医院全科医学科,325000 [2]西藏自治区山南市措美县古堆乡卫生院,856900 [3]浙江省丽水市人民医院全科医学科,323000 [4]浙江省台州医院全科医学科,318000 [5]温州市龙湾区瑶溪社区卫生服务中心,325024 [6]温州市永嘉县岩头卫生院,325100 [7]温州市苍南县钱库中心卫生院,325804

出　　处：《中华全科医师杂志》2021年第1期67-72,共6页Chinese Journal of General Practitioners

摘　　要：目的了解浙南地区基层医疗机构全科医生急救技能和基层医疗机构急救设施配置情况。方法自行设计浙南地区基层全科医生急救技能和设施调查表,对温州、台州和丽水地区的169家基层医疗机构的480名全科医生进行问卷调查。问卷内容包括:全科医生一般资料,心肺复苏、电除颤、气管插管等急救技术掌握情况及对其在基层急救中的重要性评价,常见急危重病抢救能力、识别与转诊能力等急救应对能力是否掌握及对其在基层急救中的重要性评价,基层医疗机构心肺复苏机、心电图、床边超声等急救设施配置情况和全科医生对其在基层急救中的重要性评价。共发放问卷480份,回收有效问卷447份(93.1%)。结果447名全科医生中男性占55.9%(250/447),本科及以上学历者占70.9%(317/447),中、高级职称者占60.2%(269/447)。急救技术方面重要性评价较高者依次为心肺复苏术99.6%(445/447)、电除颤术86.6%(387/447)、呼吸球囊使用76.1%(340/447)、气管插管术69.8%(312/447),其掌握率分别为84.3%(377/447)、32.0%(143/447)、55.2%(247/447)和12.9%(58/447)。急救应对能力方面重要性评价最高者为危重症抢救能力92.4%(413/447),其掌握率为32.4%(145/447);认为床边超声应用能力重要者41.4%(185/447),其掌握率为3.8%(17/447)。在急救设施配置方面认为心肺复苏机重要者77.4%(346/447),医疗机构的配备率为16.0%(27/169);重要性评价较高的急救特检项目为心电图98.9%(442/447)、超声检查88.4%(395/447),医疗机构配备率分别为98.2%(166/169)和84.0%(142/169)。结论浙南地区基层医疗机构全科医生对心肺复苏技术掌握较好;对电除颤、气管插管、急危重症抢救掌握率较低,对其重要性认识有较大差异。Objective To survey the first-aid ability of general practitioners(GPs)and the emergency service capacity of primary health institutions in southern Zhejiang province.Methods The questionnaire of first-aid ability of GPs in primary care institution was developed on the basis of the Delphi method during August to October 2018.The questionnaire was employed in a survey on the first-aid ability among 480 GPs from 169 community health service centers of three regions in southern Zhejiang province.The survey covered basic information and first-aid skills and emergency response ability of GPs,and the emergency facilities of primary health institutions.Results A total of 480 questionnaires were distributed and 447 were retrieved with an recovery rate of 93.1%(447/480).Among the 447 responders,55.9%(250/447)were males,70.9%(317/447)had bachelor′s degree or above,and 60.2%(269/447)had middle and senior professional titles.There were 99.6%(445/447),86.6%(387/447),76.1%(340/447)and 69.8%(312/447)responders considered cardiopulmonary resuscitation(CPR),electrical defibrillation,respiratory balloon and endotracheal intubation as important first-aid skills,and corresponding mastery rates were 84.3%(377/447),32.0%(143/447),55.2%(247/447)and 12.9%(58/447),respectively.The 92.4%(413/447)responders thought that the rescue ability of common emergency and critical illness was the most important,while only 32.4%(145/447)responders mastered it.Least responders[41.4%(185/447)]thought that ability of using bedside ultrasound was important,and the corresponding mastery rate was only 3.8%(17/447);77.4%(346/447)of general practitioners believed that CPR machines was important,while the available rate of CPR machines in primary health care institutions was only 16.0%(27/169).Conclusion The GPs in southern Zhejiang province have a good grasp of cardiopulmonary resuscitation skills,but have a low mastery rate of first-aid skills such as electrical defibrillation,tracheal intubation,and emergency rescue capabilities,which are quite different

关 键 词：急救医疗服务 全科医生 急救能力 基层医疗机构 

分 类 号：R197.1[医药卫生—卫生事业管理]