肺功能检查技术在基层医疗卫生机构推广可行性及建议

Feasibility and Suggestions on the Promotion of Pulmonary Function Test in Primary Health Care Institutions

大多数慢性阻塞性肺疾病(COPD)患者首次就诊在基层医疗卫生机构,但我国呼吸系统慢性病的整体防治水平不容乐观。基层医生对COPD诊治防的认知不足,肺功能检查使用率低,诊疗不规范,漏诊、误诊发生率高。为了做好呼吸系统慢性病基层防治,减少漏诊、误诊的发生,有效控制呼吸系统慢性病的发生率和致死率,本文运用SWOT分析法对肺功能检查技术在基层医疗卫生机构推广的优势和劣势以及结合当前社会环境的机遇和风险进行系统分析。分析发现肺功能检查技术作为呼吸疾病诊断、病情监测及疗效评估的重要手段,具有无创、重复检测方便、灵敏度高、价格便宜等自身优势,而且呼吸界陆续出台有关肺功能检查技术操作指南,结合当前呼吸系统慢性病防治政策利好,肺功能检查质控体系已建立,可以为在基层医疗卫生机构呼吸系统慢性病筛查应用提供技术和政策保障。但当下也存在肺功能检查从业人员水平参差、基层对肺功能检查应用意识薄弱、社区居民对呼吸系统慢性病早防早治意识薄弱、缺乏健康促进的支持等问题。据此,本文认为肺功能检查技术在基层医疗卫生机构应用推广是实现呼吸系统慢性病患者群体筛查和诊断的一项重要且可行的举措,并为基层医疗卫生机构开展呼吸系统慢性病防控提出系列建议。

The overall level of prevention and treatment of chronic respiratory diseases is not optimistic in China.Most patients with chronic obstructive pulmonary disease(COPD)choose primary health care institutions for their first visit,but they may have a high possibility of getting a missed diagnosis or misdiagnosis due to primary care physicians'insufficient knowledge of diagnosis,treatment and prevention of COPD,low utilization rate of pulmonary function test and nonstandard diagnosis and treatment procedure.To improve the prevention and treatment of chronic respiratory diseases,and achieve satisfactory reduction in the possibilities of missed diagnosis and misdiagnosis,and good control of incidence and mortality of these diseases in primary care,we performed a SWOT analysis of the application of pulmonary function test in primary care under China's current social environment.And we summarized that pulmonary function test is an important means for diagnosing,monitoring and evaluating the therapeutic effect in respiratory diseases in primary care owning to non-invasive,easy to carry out repeated test,highly sensitive and inexpensive features,with technique and policy support guarantees for chronic respiratory disease screening from operation manuals of pulmonary function test successively issued by the respiratory disease field,and a relatively well-developed quality control system for pulmonary function test as well as favorable policies support the prevention and treatment of chronic respiratory diseases.The problems were also summarized,such as uneven professional level of practitioners,poor awareness of the application of pulmonary function test in primary care,weak awareness of early prevention and treatment of chronic respiratory diseases among community residents,and lack of support for health promotion.According to these,we suggested that the application and popularization of pulmonary function test in primary health care is an important and feasible measure to realize chronic respiratory disease screening and diagnosis,and put forward a series of recommendations for the prevention and control of these diseases in primary health care institutions.