甘肃省146家医疗机构结核病实验室现状初步调查分析  

Preliminary investigation and analysis on the current situation of tuberculosis laboratories in 146 medical institutions in Gansu Province

作　　者：孔宛如 张浩军 吴明华 胡逢静 张映华[1] 林霞 Kong Wanru;Zhang Haojun;Wu Minghua;Hu Fengjing;Zhang Yinghua;Lin Xia(Department of Infection Management,Gansu Provincial People’s Hospital,Lanzhou 730099,China;Second Provincial People’s Hospital of Gansu,Lanzhou 730099,China;School of Public Health,Lanzhou University,Lanzhou 730013,China;Department of Infection Management,the Frist Hospital of Lanzhou University,Lanzhou 730030,China;Department of Infection Management,Chengguan People’s Hospital,Lanzhou 730030,China)

机构地区：[1]甘肃省人民医院感染管理科,兰州730099 [2]甘肃省第二人民医院,兰州730099 [3]兰州大学公共卫生学院,兰州730000 [4]兰州大学第一医院感染管理科,兰州730013 [5]兰州市城关区人民医院感染管理科,兰州730030

出　　处：《结核与肺部疾病杂志》2023年第1期54-59,共6页Journal of Tuberculosis and Lung Disease

基　　金：兰州市科技局项目(2018-3-62);甘肃省科技厅项目(21JR1RA034)。

摘　　要：目的:了解甘肃省医疗机构结核病实验室现状,为解决现存问题提供参考。方法:2021年7月21日至2021年8月10日,甘肃省150家设有结核病实验室的医疗机构实验室负责人通过扫描甘肃省卫生健康委员会发布的文件附件中的二维码填写课题组自行设计的网络问卷,主要内容包括医院的基本信息、结核病实验室检测项目开展情况、实验室感染控制管理情况、手卫生与防护设备的配置和标识的配置等。共回收问卷150份,其中有效问卷146份,问卷有效率为97.33%。结果:146家医疗机构中,二级医院、三级医院和未定级医院分别有96家(65.75%)、38家(26.03%)和12家(8.22%);综合医院和专科医院分别为97家(66.44%)和49家(33.56%)。开展抗酸杆菌涂片镜检、分枝杆菌培养和药物敏感性试验(简称“药敏试验”)的医疗机构分别有146家(100.00%)、116家(79.45%)和99家(67.81%),其中,专科医院开展分枝杆菌培养和药敏试验的比例[分别为91.84%(45/49)和87.76%(43/49)]均明显高于综合医院[分别为73.20%(71/97)和57.73%(56/97],差异均有统计学意义(χ^(2)=6.929,P=0.008;χ^(2)=13.443,P<0.001)。实验室感染控制管理方面的薄弱环节是仅有80家(54.79%)实验室有预防工作人员感染风险的疫苗接种计划,有5家(3.42%)实验室废物不能够进行分类管理,有20家(13.70%)实验室未能配置生物安全柜(二级医疗机构为17家);96家二级医院中,未清晰标示出清洁区、缓冲区、污染区和未进行生物实验室风险评估的各有13家(13.54%),并有11家(11.46%)未对实验室保洁人员进行定期培训;97家综合医疗机构中有7家未制定结核病实验室准入制度流程(7.22%)。而设施配置和重要标识配置方面的薄弱环节分别为未定级医院护目镜和洗手图的配置率[均为83.33%(10/12)]、操作致病性生物因子和生物防护级别的标识配置率[分别为74.66%(109/146)和85.62%(125/146)]均较低,且三级医院中有5家(13Objective:To investigate the current situation of tuberculosis laboratories in medical institutions in Gansu Province and provide reference for proposing countermeasures.Methods:One hundred and fifty medical institutions with tuberculosis laboratories in Gansu Province filled out the self-designed online questionnaires by scanning QR codes attached to documents issued by the Health Commission between July 21 and August 10,2021.The contents of the questionnaire included the basic information of the hospital,the development of the tuberculosis laboratory testing projects,the management of infection control,the configuration of hand hygiene and protective equipment,and the configuration of identification,etc.A total of 150 questionnaires were recovered,of which 146 were valid,with an effective rate of 97.33%.Results:Among the 146 medical institutions,96(65.75%)were secondary hospitals,38(26.03%)were tertiary hospitals,12(8.22%)were ungraded hospitals;97(66.44%)general hospitals and 49(33.56%)specialized hospitals;146(100.00%)hospitals carried out acid-fast bacillus smear microscopy,116(79.45%)carried out mycobacterium culture,and 99(67.81%)carried out drug susceptibility testing.The proportion of mycobacterial culture and drug susceptibility testing in specialized hospitals(91.84%(45/49)vs.87.76%(43/49),respectively)was significantly higher than that in general hospitals(73.20%(71/97)vs.57.73%(56/97),respectively),the differences were statistically significant(χ2=6.929,P=0.008;χ2=13.443,P<0.001).Weaknesses in laboratory infection control management were that only 80(54.79%)laboratories had vaccination programmes to prevent infection risk,5(3.42%)laboratories could not classify laboratory waste,and 20(13.70%)laboratories could not deploy biosafety cabinets(17 were secondary medical institutions).Among the 96 secondary hospitals,13(13.54%)hospitals did not clearly mark the clean area,buffer zone,contaminated area and did not conduct biological laboratory risk assessment,11(11.46%)did not carry out regular training f

关 键 词：卫生系统机构 诊断 专业能力 数据收集 研究报告 

分 类 号：R521[医药卫生—内科学]