江苏省基层医院幽门螺杆菌感染诊治现状调查及分析  

Survey and analysis on the current status of diagnosis and treatment of Helicobacter pylori infection in primary health care centers in Jiangsu Province

作　　者：杨振 杨红梅 陈梅红[1] 杨若云 张国新[1] 叶峰[1] Yang Zhen;Yang Hongmei;Chen Meihong;Yang Ruoyun;Zhang Guoxin;Ye Feng(Department of Gastroenterology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Gastroenterology,Mufu Mountain Community Hospital,Nanjing 210028,China)

机构地区：[1]南京医科大学第一附属医院消化科,南京210029 [2]南京市幕府山社区医院消化科,南京210028

出　　处：《中华消化杂志》2023年第9期599-604,共6页Chinese Journal of Digestion

基　　金：江苏省六大人才高峰(2018-WSW-003);南京市浦口区社会事业科技发展计划(S2021-1)。

摘　　要：目的调查江苏省基层医院开展幽门螺杆菌(H.pylori)感染诊治的现状,评估基层医院对H.pylori感染综合防治管理的能力。方法对2020至2022年参加江苏省基层消化科特色科室孵化中心项目的430家基层医院进行问卷调查。问卷内容包括胃镜室和消化专科设立情况、H.pylori检测项目种类、H.pylori治疗药物种类、根除方案及疗程等。问卷由基层医院专业负责人填写。统计学方法采用描述性分析。结果共收到413份有效问卷,其中286家(69.2%)基层医院配备胃镜室,202家(48.9%)设有消化专科;H.pylori检测条件方面,148家(35.8%)基层医院尚无尿素呼气检测设备,其中84家未开展任何H.pylori检测项目,8家仅有快速尿素酶检测,45家仅有血清H.pylori抗体检测,7家同时有快速尿素酶和血清H.pylori抗体检测,4家有粪便H.pylori抗原检测;治疗药物方面,所有基层医院均能提供质子泵抑制剂,342家(82.8%)能提供铋剂;根据H.pylori感染基层诊疗指南推荐的7个2种抗生素组合方案,仅14家(3.4%)基层医院能提供所有组合,369家(89.3%)能提供2~6个组合,20家(4.8%)仅能提供1个组合,10家(2.4%)无法提供规范的药物组合;根除方案及疗程方面,248家(60.0%)选择含铋剂四联方案,363家(87.9%)选择14 d疗程,232家(56.2%)家选择含铋剂的四联方案且疗程为14 d。结论完善基层医院H.pylori检测设备,备齐治疗药物种类,提高基层医师对H.pylori诊治认知水平,对提高基层H.pylori感染防治成效具有重要意义。Objective To investigate the current status of diagnosis and treatment of Helicobacter pylori(H.pylori)infection in primary hospitals in Jiangsu Province,and to evaluate the capability of comprehensive prevention and management of H.pylori infection in the primary hospitals.Methods From 2020 to 2022,a questionnaire survey was conducted among 430 primary hospitals,which participated in the Incubation Center Project of Primary Gastroenterology Specialty Department in Jiangsu Province.The questionnaire survey includedthe establishmment of endoscopy and department of gastroenterology,items of H.pylori detection,H.pylori treatment,eradication plans and treatment course.The questionnaire was filled by the director of the primary hospital.Descriptive analysis was used for statistical analysis.Results A total of 413 valid questionnaires were received.Among the 413 primary hospitals,286(69.2%)were equipped with endoscopy centers,and 202(48.9%)had departments of gastroenterology.In terms of diagnostic methods for H.pylori,35.8%(148/413)of the primary hospitals did not have urea breath test equipment,of which 84 hospitals did not carry out any H.pylori testing items,8 hospitals only had rapid urease test,45 hospitals only had serum H.pylori antibody test,7 hospitals had both rapid urease test and serum H.pylori antibody test,and 4 hospitals had fecal H.pylori antigen test.In terms of therapeutic drugs,all the hospitals could provide proton pump inhibitors,and 82.8%(342/413)of the hospitals had bismuth agents.According to diagnosis and treatment guideline for H.pylori infection at the primary care,7 combinations of two antibiotics were recommended.A total of 14(3.4%)hospitals could provide all the combinations,369(89.3%)hospitals could provide 2 to 6 combinations,20(4.8%)hospitals could provide only one combination,and 10(2.4%)hospitals could not provide any combination.For the selection of the eradication scheme and treatment course,the bismuth-based quadruple scheme was chosen in 248(60.0%)hospitals,14-day course was selec

关 键 词：基层医院 幽门螺杆菌感染 指南 调查和问卷 现状调查 

分 类 号：R573.1[医药卫生—消化系统]