贵州省伤寒、副伤寒高发地区医院诊断能力调查

Investigation on the diagnostic abilities of hospital in high-risk areas of typhoid fever and paratyphoid fever in Guizhou Province

目的了解贵州省伤寒、副伤寒高发地区医院诊断能力,为全省伤寒、副伤寒诊断及报告质量的提高提供参考。方法利用2009-2013年报告的伤寒、副伤寒病例资料,确定发病率前5位的地区。在每个高发地区随机抽取医院,然后在每个医院抽取医护人员、实验室。对医护人员伤寒、副伤寒诊断标准掌握情况及医院实验室诊断条件展开调查。结果共抽取医护人员215人,最高分85分,最低分30分,平均(66.67±12.54)分,不同学历(F=24.06,P<0.01)、不同卫生技术职称(F=12.14,P<0.01)、不同医院等级(F=66.56,P<0.01)得分差异有统计学意义。调查28家医院实验室,其中有11家没有开展检验工作,占39.29%;在17家开展检验的实验室中,不能进行伤寒、副伤寒病原培养的有7家(占41.18%),不能开展肥达氏反应的有6家(占35.29%)。结论高发地区医院医护人员伤寒、副伤寒诊断标准得分偏低,实验室伤寒、副伤寒检验工作不完善,两个方面的不足影响了医护人员的诊断能力。

Objective To find out the diagnostic abilities of hospital in high-risk areas of typhoid fever and paratyphoid fever in Guizhou,then to provide a scientific basis for improving diagnostic accordance rate and the report quality. Methods The clinical date of typhoid fever and paratyphoid fever reported from 2009 to 2013 was used to determine the incidence of five former regions. The hospital was selected randomly in each high-risk area,then to select the medical stuff and laboratories at each hospital. Investigating the mastering situation on diagnostic criteria for typhoid fever and paratyphoid fever of the medical staff and the situation on laboratory diagnosis. Results The 215 medical staff were collected in this investigation,and the highest score was 85,the lowest score was 30,the average was（ 66. 67 ± 12. 54）. There was statistical significance among education background（ F = 24. 06,P 〈 0. 01）,health professional titles（ F = 12. 14,P 〈 0. 01） and hospital hierarchies（ F = 66. 56,P 〈 0. 01） in the aspect of scores. The 11 laboratories（ 39. 29%） did not carry out the inspection work in the 28 labs investigated. There were 7 labs can not cultured bacteria（ 41. 18%） and 6 labs can not carry out widal reaction（ 35. 29%）. Conclusion The scores on diagnostic criteria among medical staff was lower. The laboratory did not have perfect inspection work in the typhoid fever and paratyphoid fever aspect. Diagnostic abilities was affected by this two aspects.