Objective To observe the current situation of clinical diseases of patients in township hospitals in Jiangsu Province in order to explore its guiding significance of general practice education.Methods Using purposive sampling,12 representative township hospitals were selected in Jiangsu Province from July 13 to August 15 of the year 2015,of which three township hospitals were selected from the southern area of Jiangsu,three were from the central area and six were from the northern area.A self-designed questionnaire was used to collect the diagnosis and treatment information of consulting patients in 12 township hospitals from June 2014 to June 2015.Key points of the outline of the assistant medical practitioner examination were analyzed comparing with the situation of clinical diseases of patients in township hospitals of Jiangsu Province.Results A total of 636 638 patients were enrolled in this study,including 440 829 (69.24％) patients from the department of internal medicine,55 060 (8.65％) patients from the department of surgery,35 091 (5.51％) patients from the department of obstetrics and gynecology,61 850 (9.72％) patients from the department of pediatrics,37 218 (5.85％) patients from the ophthalmology and otorhinolaryngology,and 2 239 (0.35％) patients from the department of dermatology.There were significant differences in the distribution of diseases among township hospitals in the southern,central and northern areas of Jiangsu Province (P ＜ 0.05).Compared with the examination outline,medical diseases,surgical diseases and obstetrics and gynecology diseases of patients in township hospitals almost covered the disease categories of these aspects in the oudine,but no patients with some kind of infectious diseases were found in township hospitals.The knowledge of blood transfusion,perioperative treatment,nutrition (surgery),and family planning (obstetrics and gynecology) about which the township hospitals needed to increase was also required in the examination outline.Pediatric diseases of patients in township hospitals covered most of disease categories in this aspect in the outline.The infantile obesity,zinc deficiency,stomatitis and viral encephalitis were not included in the outline but these diseases were found in township hospitals.The dermatology diseases and ophthalmology and otorhinolaryngology diseases of patients in 12 township hospitals were far beyond the outline.Conclusion The disease categories treated in township hospitals of Jiangsu Province covered a wide range,which brings up higher requirements of general practitioners especially in surgery diseases,obstetrics and gynecology diseases,and pediatric diseases in order to balance the development of basic medical care in the southern,central and northern areas of Jiangsu Province.%目的 了解江苏省乡镇卫生院的接诊疾病情况,并探讨其对全科医学教育的指导意义.方法 于2015-07-13至2015-08-15,采用立意抽样法在江苏省选取乡镇卫生院12所,其中苏南地区3所、苏中地区3所、苏北地区6所.采用自制“基层疾病调查问卷”收集该12所乡镇卫生院2014年6月--2015年6月的接诊疾病情况;解析执业助理医师资格考试大纲(考试大纲),并将其与乡镇卫生院的接诊疾病情况进行对比分析.结果 12所乡镇卫生院共接诊患者636 638人次,其中内科、外科、妇产科、儿科、五官科、皮肤科分别接诊患者440 829人次(69.24％)、55 060人次(8.65％)、35 091人次(5.51％)、61 850人次(9.72％)、37 218人次(5.85％)、2 239人次(0.35％).苏南、苏中、苏北地区乡镇卫生院接诊的疾病类别分布比较,差异有统计学意义(P＜0.05).与考试大纲要点进行对比:乡镇卫生院接诊的内科、外科及妇产科疾病几乎覆盖了考试大纲要点,但考试大纲中要求掌握的部分传染性疾病(内科)在乡镇卫生院中无接诊患者,大纲中要求的外科和妇产科基础知识还包括输血、围术期处理、营养(外科)及计划生育(妇产科),需注意补充;乡镇卫生院接诊的儿科疾病覆盖了考试大纲中大部分要点,但乡镇卫生院中接诊的小儿肥胖症、锌缺乏症、口炎、病毒性脑炎在考试大纲中未涉及;乡镇卫生院接诊的皮肤科和五官科疾病远超出考试大纲要点.结论 江苏省乡镇卫生院的接诊疾病涵盖面较广,对全科医生医疗服务能力要求较高,需提升其外科、妇产科、儿科门诊的服务能力,协调苏南、苏中、苏北地区基本医疗平衡发展.
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