广东省县级医疗卫生服务机构宫颈癌筛查能力现状分析  

Analysis of cervical cancer screening capacity of county-level health service institutions in Guangdong Province

作　　者：武丽[1] 曾祖瑞 梅平[3] 陈国珍[2] 梁咏欣 夏建红[1] 韦相才 WU Li;ZENG Zu Rui;MEI Ping;CHEN Guo Zhen;LIANG Yong Xin;XIA Jian Hong;WEI Xiang Cai(Guangdong Women and Children Hospital,Guangzhou 511400,Guangdong Province,China;Jinan University,Guangzhou 510055,Guangdong Province,China;Guangdong Provincial People’s Hospital,Guangzhou 510440,Guangdong Province,China)

机构地区：[1]广东省妇幼保健院,广东广州511400 [2]暨南大学,广东广州510055 [3]广东省人民医院,广东广州510440

出　　处：《中国妇幼卫生杂志》2023年第2期45-50,共6页Chinese Journal of Women and Children Health

基　　金：2019年广州市科学研究计划一般项目专题(201904010026);2022年度广东省医学科研基金项目(C2022036)。

摘　　要：目的通过调查了解广东省宫颈癌筛查项目地区县级医疗卫生服务机构宫颈癌筛查服务能力现况,为今后有针对性地提高项目地区宫颈癌筛查服务能力和管理质量水平提供依据。方法选择广东省119个宫颈癌筛查项目管理单位为调查对象,并开展问卷调查。调查的主要内容包括宫颈癌筛查的基本情况,以及机构在人乳头瘤病毒(human papilloma virus,HPV)检测、细胞学检测、阴道镜检查、组织病理学检查及项目管理方面的人员能力建设情况。结果广东省宫颈癌筛查项目管理机构主要是县(市、区)卫生健康局,项目主要实施机构和初筛机构为县(市、区)妇幼保健院,HPV高危分型检测是目前主要的宫颈癌初筛方法。在154家实施妇女宫颈癌筛查的县(市、区)级医疗机构中,59家(38.31%)机构拥有HPV检测项目专职人员,39家(25.32%)机构拥有细胞学检查专职人员,100家(64.94%)机构拥有阴道镜检查项目专职人员,29家(18.83%)机构拥有组织病理学检查项目专职人员;44家(28.57%)宫颈癌筛查专职人员接受过上级HPV检测培训,27家(17.53%)宫颈癌筛查专职人员接受过上级细胞学检查培训,102家(65.23%)宫颈癌筛查专职人员接受过上级阴道镜检查培训,22家(12.99%)宫颈癌筛查专职人员接受过上级组织病理学检查培训。154家筛查机构中分别有63.64%、75.32%及73.38%的机构外送第三方检测机构进行HPV检测、细胞学检查和组织病理学检查。结论在与第三方检测机构联合下,广东省大部分开展宫颈癌筛查工作的县级医疗机构基本具备宫颈癌初筛的能力,但县级医疗机构对宫颈癌筛查项目专职人员投入较少,在HPV和细胞学检测方面,主要依赖于第三方检测机构。政府和上级部门应加强对第三方检测机构的统一管理,重视基层医疗人才的培养,增强基层医疗机构的筛查能力。Objective To investigate the current situation of cervical cancer screening service capacity of county-level health service institutions in the project areas of Guangdong province,in order to provide evidence for the improvement of their screening capacity in the future.Methods A questionnaire survey was conducted in 119 cervical cancer screening project management units in Guangdong Province.The main contents of the survey included the general information of cervical cancer screening,and the staff capacity building in terms of human papilloma virus(HPV)detection,cytology detection,colposcopy inspection,histopathology examination and project management.Results Cervical cancer screening project in Guangdong Province was mainly administrated by the county health bureau,and the county maternal and child health hospital was mainly responsible for implementation and primary screening.High risk HPV typing test was the main screening method.Among all 154 cervical cancer screening county-level health service institutions,the percentage of full-time staff and those who received superior training from upper level for HPV testing,cytological examination,colposcopy inspection and histopathology examination were 38.31%(59),25.32%(39),64.94%(100),18.83%(29)and 28.57%(44),17.53%(27),65.23%(102),12.99%(22),respectively.There were 63.64%HPV testing,75.32%cytological examination and 73.38%histopathology examination done by professional third party testing institutions.Conclusion Under the joint cooperation with third-party testing institutions,most county-level medical institutions are capable of carrying out cervical cancer primary screening project in Guangdong Province,but they mainly rely on third-party institutions for HPV testing and cytological examination,and investment on full-time staff is insufficient.The government and higher authorities should strengthen unified management of third-party institutions,attach importance to training of grass-roots medical personnel,and enhance screening capacity of grass-roots medical in

关 键 词：县级医疗机构 宫颈癌 癌症筛查 筛查能力 

分 类 号：R737.33[医药卫生—肿瘤]