武汉市部分社区基层医院支气管哮喘防治现状及对策

Current Situation of Asthma Control and Countermeasures in Community Hospitals in Wuhan

目的了解武汉市部分社区基层医院支气管哮喘（简称哮喘）防治现状，分析原因并作出相应对策。方法采用现场调查的方法对武汉市武昌区卫生局和洪山区卫生局所管辖范围内的10个社区卫生服务中心和2个社区卫生服务站的哮喘控制现状进行调查。结果所有被调查的医疗机构对与哮喘诊治相关的医疗设备、药物和专科医生配置很不齐全。医院的内科医生对现代哮喘诊治及管理相关知识掌握很不全面。患者的治疗不规范，吸入糖皮质激素、规律随访、使用峰流速仪的患者比例低，分别是31．7％、15．0％、3．3％，29．2％的患者曾经和正在服用成分不明的平喘药，哮喘急性发作期抗生素使用率达86．7％，慢性持续期不予治疗的患者比例高达65．0％，哮喘控制水平很差，良好控制以上组仅占28．3％。结论武汉市部分社区基层医院哮喘防治现状形势十分严峻，要推广执行GINA方案，加大社区基层医院哮喘防治力度。

Objective To explore current situation of asthma control and treatment in some community hospitals in Wuhan and analyze causes as well as countermeasures. Methods 12 community hospitals in Wuchang and Hongshart districts were investigated for current situation of asthma control. Results Medical equipment, medication and specialist physicians on asthma control were not complete in all medical institutions investigated. Doctors lacked the knowledge on asthma diagnosis, treatment and management. The treatment on asthma was not standard. Rates of in- haled glucocorticoids, regular follow- up, and usage of peak flow meter were 31.7%, 15.0% and 3.3 %. 29.2% of patients had taken and were taking antiasthmatic drugs with unknown components. 86.7% of patients took antibiotics on acute attack of asthma. 65.0% of patients did not receive treatment on chronic persistent. The control level of asth- ma was very low. The percentage of well - controlled groups was only 28.3%. Conclusion The situation of asthma control in community hospitals in Wuhan is serious. GINA guidelines need to be generalized and implemented. Asthma control must be reinforced in community hospitals.