全球哮喘防治创议在基层医疗推广应用分析

The Application Analysis about the Global Initiative for Asthma in the Primary Hospital

目的了解《全球哮喘防治创议》(GINA方案)在基层医院的推广应用情况。方法选取2006年1月至2009年3月在孝感市孝南区妇幼保健院哮喘专科就诊的门诊和住院哮喘患儿156例,通过患儿就诊或医务人员随访时问诊患儿家属,了解患儿在当地用药情况、哮喘控制情况及问卷调查孝感市区各级医院儿科医师,了解医务人员GINA方案推广情况。结果基层医院在GINA方案推广应用中存在着一些问题:医务人员自身理论知识缺乏,GINA方案培训率不高;哮喘诊断不清;急性发作期治疗不当;间歇期吸入治疗不规范;吸入药物方法不正确及患儿家属依从性差等几个方面。结论GINA方案在基层医院的推广应用工作还远远不够,为进一步控制我国儿童哮喘,必须重视基层医院哮喘的培训和宣教工作,把基层医院的哮喘防治工作放在一个重要的位置。

Obbective In order to understand the application and promotion of ＂the Global Initiative for Asthma＂ （referred to as GINA program） at the primary hospital. Methods We have selected from 156 cases in Xiaonan district women and children hospital asthma specialist out-patient clinic and hospitalized children with asthma from January 2006 to March 2009. By means of the children with medical or the medical staff inquired the family members of the sick children when they had medical follow-up diagnosis. They understood the situation of children in the local medication, asthma control and a questionnaire survey of the urban hospital paediatricians at all levels and understood the situation that the medical staff promoted GINA program. Results There were some problems when the primary hospitals promoted and used the G1NA program： there was a great shortage of the knowledge in medical staff＇s self-theory, GINA program of training rate was not high; asthma diagnosis was unclear; The treatment of acute stage was improper; The treatment of inhalation in the period of intermittent was non-standard; The inhaled drugs and methods were not quite right and the families of children were with poor compliance, etc. Conclusion It is far from enough for the work that GINA program was promoted and applicated at the grassroots level hospital. In order to further control the children＇s asthma in our country, we must pay attention to the work of the primary hospital training and education, we should put the prevention and treatment of asthma of the primary hospital in an important position.