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目的了解并评价安徽省部分地区肠道门诊的现况并针对发现的问题提出相应对策。方法随机选择安徽省10个地市的33家医疗机构肠道门诊开展调查,包括肠道门诊设置、工作开展情况;2004~2011年8月霍乱首例病例就诊情况。结果二级及以上医院肠道门诊中独立区域的占45.0%;二级及以上医院独立区域肠道门诊中“五室”独立的占33.3%、“四室”独立为11.1%,“三室”独立为55.6%。设置隔离室的肠道门诊占51.5%。二级及以上医院的肠道门诊感应式或肘控式洗手设施占63.2%,厕所以水冲式专用厕所为主,占75.0%。一级医院的肠道门诊均为手拧式洗手设施,厕所水冲式共用厕所为主,占61.5%。多数二级及以上医院急诊分流腹泻病人的比例高于(消化)内科,平均分流率5.5%,最高17.0%。检查的医疗机构中2011年能够开展霍乱弧菌培养工作的占63.6%,二级及以上医院均能开展霍乱弧菌培养工作,一级医院仅1家开展此项工作。2004~2011年8月,有10个市共报告了30例霍乱病例,其中有5例当年首例霍乱病例由肠道门诊发现。结论肠道门诊设置和工作不规范,需要进一步加强建设,规范工作流程和制度。
Objective To understand and evaluate the status of gut clinics in some areas of Anhui Province and to put forward corresponding countermeasures for the problems discovered. Methods A total of 33 medical institutions in 10 cities of Anhui Province were enrolled in the study, including the establishment of gut outpatients and their work progress. The first case of cholera in August 2004 to August 2011 was investigated. Results Grade II and above hospitals accounted for 45.0% of the independent clinics in the gut outpatient clinics; 33.3% were independent in the gut clinics of Grade II and above hospitals and 11.1% were independent in the “four rooms” , “Three Rooms” was 55.6% independent. Intestinal clinics with isolation rooms accounted for 51.5%. Intestinal outpatient induction or elbow hand-washing facilities accounted for 63.2% of the total in hospitals of secondary level and above. The toilets were mainly water-flush toilets, accounting for 75.0%. First-class hospital gut clinics are hand-wringing facilities, toilets flush-based shared toilets, accounting for 61.5%. The majority of patients in secondary level and above hospitals had higher rates of diverting and diarrhea than those receiving internal medicine, with an average shunt rate of 5.5% and a maximum of 17.0%. Among the medical institutions inspected, 63.6% of them could carry out Vibrio cholerae cultivation in 2011, and Vibrio cholerae cultivation can be carried out in hospitals of secondary and higher level. Only one hospital of Grade-I hospitals carried out this work. From 2004 to August 2011, 10 municipalities reported a total of 30 cholera cases, of which 5 were the first cholera cases found in the intestine clinic. Conclusion The establishment and work of gut clinics are not standardized, so we need to further strengthen the construction and standardize workflow and system.