重视第四级预防 构建五级预防理论框架

詹思怡; 许锐恒; 傅传喜

doi:10.11847/zgggws1128892

重视第四级预防构建五级预防理论框架

doi: 10.11847/zgggws1128892

1.
浙江中医药大学公共卫生学院流行病学教研室，浙江杭州 310053
2.
广东省疾病预防控制中心

详细信息

作者简介:
詹思怡（1996 – ），女，浙江杭州人，硕士在读，研究方向：基于大数据的疫苗效果评估

通讯作者:
傅传喜，E-mail：fuchuanxi@zcmu.edu.cn

中图分类号: R 19
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- 被引次数: 0
出版历程
- 接收日期: 2020-03-11
- 网络出版日期: 2021-01-12
- 刊出日期: 2020-12-10

Importance of fourth-level prevention strategy and theoretical framework construction for five-level prevention: a brief discussion

1.
Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province 310053, China

摘要

摘要: 四级预防策略（零级、第一级、第二级及第三级预防）分别对应于疾病的不同发展阶段，已在中国疾病预防控制实践中发挥了巨大的作用。第四级预防指确定医疗机构中可能出现过度医疗及医源性疾病风险的个人（群体）通过干预降低或避免额外的医疗入侵，对不同的疾病发展阶段和医学干预阶段的预防策略进行分级，构建五级预防理论框架，可更加精准地指导我国的公共卫生及医学实践。为此，本文简要回顾了中国现有的预防策略，对第四级预防的概念和内涵进行了系统阐述，完善了五级预防理论框架，以期为中国疾病预防控制工作提供新的理论依据。
- 第四级预防 /
- 五级预防 /
- 理论框架
Abstract: The four-level prevention strategy (including the zero level prevention, primary prevention, secondary prevention, and tertiary prevention) corresponding to different stages of a disease has played a huge role in the practice of disease prevention and control in China. Quaternary prevention aims to identify individuals (groups) at the risk of over-medication or iatrogenic diseases and decrease or avoid excessive medication and sanitary intervention through intervention. By grading prevention strategies at different stages of a disease development or medical intervention and constructing a five-level prevention theoretical framework, public health practices and medical services in China could be under more accurate guidance. The study briefly reviewed the development of prevention strategies in China, systematically explained the concept and connotation of fourth-level prevention and summarized the theoretical framework of five-level prevention for providing a theoretical basis to disease prevention and control practice in China.
- fourth-level prevention /
- five-level prevention /
- theoretical framework

HTML全文

图 1 五级预防模型图

下载: 全尺寸图片幻灯片

图 2 新型冠状病毒肺炎五级预防

下载: 全尺寸图片幻灯片

表 1 五级预防干预时序表

五级预防	干预时间	对象	目标
零级预防	疾病前期	国家　社区　人群	减少危险因子出现
第一级预防	疾病前期	社区　人群	减少或控制疾病的发生
第二级预防	疾病早期	特定人群　健康个体	降低死亡率
第三级预防	临床期或康复期	医院　患者	治疗　康复　减少并发症和死亡
第四级预防	疾病全过程	医院卫生机构患者	预防医院感染过度医疗

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