上海市二级医院2017年慢性阻塞性肺疾病诊疗条件调查

Survey of the diagnosis and treatment conditions of chronic obstructive pulmonary disease in secondary hospitals in Shanghai in 2017

目的:了解上海市二级医院慢性阻塞性肺疾病(以下简称慢阻肺)诊疗条件现况,为慢阻肺防控工作提供参考。方法:对上海市16个区58家区属二级医院进行问卷调查,内容包括2017年时的肺功能检查仪配备及应用、慢阻肺治疗药物配备等情况。结果:在肺功能检查仪配备及应用方面,93.1%的二级医院已配备肺功能检查仪,89.7%的二级医院已开展肺功能检查,但肺功能检查应用频率低,月均检查次数<30次的二级医院占比为29.3%。在治疗药物配备方面,支气管扩张剂和糖皮质激素制剂的配备率分别为98.3%和79.3%,但长效β_(2)受体激动剂与抗胆碱能药物复方制剂的配备率只有20.7%。从医院所处区域看,远郊区域二级医院的慢阻肺诊疗条件与城区和近郊二级医院有一定的差距。结论:上海市二级医院肺功能检查应用频率低,部分慢阻肺治疗药物配备不足,且区域间的发展不平衡。二级医院应重视肺功能检查的宣传和推广工作,完善慢阻肺治疗药物的配备,优化远郊区域二级医院的资源配置。

Objective:To understand the current status of the conditions for the diagnosis and treatment of chronic obstructive pulmonary disease(COPD)in secondary hospitals in Shanghai,so as to provide reference for the prevention and control of COPD.Methods:A questionnaire survey was conducted in 58 district secondary hospitals in Shanghai,including the allocation and application of pulmonary function test apparatus(PFTA),the allocation of specific drugs for COPD in 2017.Results:In terms of the allocation and application of PFTA,the proportion of hospitals equipped with PFTA reached 93.1%and the proportion of hospitals conducted pulmonary function test reached 89.7%,however,the application frequency of pulmonary function test was low,and the average number of tests per month was no more than 30,accounting for 29.3%.In terms of drug allocation,the allocation rates of bronchodilators and glucocorticoids were 98.3%and 79.3%,but the compound preparation of long acting β_(2) agonist and long acting muscarinic antagonist only accounted for 20.7%.From a regional perspective,there was a certain gap in the diagnosis and treatment conditions for COPD between the secondary hospitals located in the exurb and the suburb.Conclusion:The application frequency of pulmonary function test in the secondary hospitals of Shanghai was low,some drugs for COPD were insufficient and the development among regions is imbalanced.Secondary hospitals should pay attention to the publicity and promotion of pulmonary function test,improve the allocation of drugs for COPD and optimize resources allocation in exurb.