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广东省狂犬病暴露预防处置门诊建设现状调查

Establishment and operation of rabies post-exposure prophylaxis clinics in Guangdong province: an online survey

  • 摘要:
    目的  了解广东省狂犬病暴露预防处置门诊建设现状,为其规范化建设提供依据。
    方法 于2021年12月 — 2022年3月,采用统一设计的问卷对广东省所有狂犬病暴露预防处置门诊的基本情况、硬件设施与人员情况、预防接种服务情况进行调查。
    结果  广东省1 184家狂犬病暴露预防处置门诊中,二级及以上医疗机构(含民营医疗机构)占17.7%、社区卫生服务中心占11.5%、乡镇卫生院占68.3%、其他类别占2.5%,多为非独立设置。88.1%的门诊设置了4大功能区域(伤口处置区、预防接种区、留观区和疑似异常反应处置区);80%以上的门诊备有扫码设备、医用冰箱、急救药品(肾上腺素、地塞米松);备有冲洗设备的门诊比例均 ≤ 62%;每个门诊预防接种人员中位数为8人,外科医生人数中位数为2人。80%以上的门诊能公示狂犬病暴露处置规范及预防接种相关信息,但分别只有49.7%和56.8%的门诊公示了预防接种后异常反应补偿政策、相关法律法规;分别有47.6%和52.6%的门诊能提供被动免疫制剂、破伤风疫苗注射服务。不同类型门诊间功能区域设置、设备配置(除自助登记取号机外)、人员配置、预防接种能力差异均有统计学意义(P均 < 0.05),二级及以上医疗机构(含民营医疗机构)均优于乡镇卫生院和社区卫生服务中心。
    结论  广东省狂犬病暴露预防处置门诊,特别是基层医疗卫生机构的狂犬病暴露预防处置门诊规范化建设有待加强。

     

    Abstract:
    Objective To examine the establishment and operation of rabies post-exposure prophylaxis clinics in Guangdong province for standard construction of the clinics.
    Methods An online survey was conducted among all rabies post-exposure prophylaxis clinics in various medical institutions across Guangdong province during December 2021 – March 2022; the information on the clinics′ general status, apparatuses and personnel allocation, operation and management were collected using a unified questionnaire.
    Results Totally 1 184 clinics were surveyed, of which, 17.7% were set up in public or private medical institutions of secondary level and above, 11.5% in community health centers, 68.3% in township hospitals, and 2.5% in other medical facilities. Four functional areas were divided in 88.1% of the clinics for wound treatment, vaccination, observation, and adverse events treatment. More than 80% of the clinics were equipped with code scanning equipment, medical refrigerator and first aid drugs (adrenalin, dexamethasone), and the proportion of clinics equipped with rinsing equipment was less than or equal to 62%. The median number of vaccinators and surgeons were 8 and 2 for all the clinics surveyed. More than 80% of the clinics were able to publicize the exposure treatment norms and other contents, but only 49.7% and 56.8% of the clinics were able to publicize the compensation policies and relevant laws and regulations for adverse event following immunization, respectively. The proportions of the clinics being able to provide passive immunization and tetanus vaccination service were 47.6% and 52.6%, respectively. There were statistically significant differences in functional area arrangement, equipment allocation, personnel allocation, service and management among the clinics in various medical institutions (P < 0.05 for all) and the clinics in public or private medical institutions of secondary level and above had better operational conditions than the clinic in township hospitals or community health centers.
    Conclusion The standardized construction of rabies post-exposure prophylaxis clinics, especially the grass-roots clinics, needs to be strengthened in Guangdong province.

     

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