广西金秀县医疗卫生现况调查和烧伤湿性医疗技术规范化推广应用研究

目录中文摘要 (1)英文摘要 (3)引言 (6)正文 (7)第一部分广西金秀县农村医疗卫生现况调查 (7)1资料与方法 (7)2结果 (11)第二部分烧伤湿性医疗技术规范化推广应用与培训..16 1培训 (17)2资料与方法 (19)3结果 (21)4讨论 (22)结论 (29)参考文献 (30)附录 (31)综述 (51)致谢 (58)攻读学位期间发表的学术论文目录 (59)作者声明 (60)个人简历 (61)中文摘要目的：通过对广西金秀县医疗现况的调查研究，了解基层卫生服务需要以及卫生服务需求者个人及社会经济负担，并以农村卫生适宜技术——烧伤湿性医疗技术（Moist expose burn therapy，MEBT）在广西基层医院的规范化推广应用情况的调查研究为例，分析农村适宜技术推广应用的现状，并进行烧伤湿性医疗技术在基层的应用规范化、标准化研究及适宜技术推广。

方法：采用问卷调查的方式，由调查员统一发放。

第一部分：调查广西金秀县基层卫生服务需要以及卫生服务需求者个人及社会经济负担。

第二部分：通过规范化培训农村医务人员，并调查培训前后烧伤湿性医疗技术的规范化推广应用情况。

结果：第一部分广西金秀县农村医疗卫生需求现况调查：调查了金秀县人民医院和金秀县瑶医院，长垌、忠良、桐木、头排4个乡镇卫生院及16个村卫生室，发放1134份调查问卷，回收有效问卷1051份，问卷有效回收率92.7%。

调查结果显示：经济的落后、文化程度低下以及交通的不便严重的影响了该地区农民的就医，同时，医疗技术成本高，病人经济负担过重，基层医院人才匮乏，乡镇医院的资金投入不足，村卫生所严重缺编等这些因素更加重了农民就医的困难，严重影响了该地区农民的健康状况。

第二部分烧伤湿性医疗技术规范化推广应用调查与培训：通过对金秀县120余名人员进行培训，取得了较大的成效，受训的120余人员基本掌握了所推广适宜医疗技术的临床应用。

在对比培训前后烧伤湿性医疗技术需求情况后发现，接受培训后医师对该技术的认知度明显高于培训前的认知度，P＜0.01，两者差异有统计学意义，而在是否需要学习该技术或推广应用中，培训前后差异无统计学意义（P>0.05，见表9）。

在对比培训前后烧伤湿性医疗技术操作规范化调查表后发现，培训后医生都能了解烧伤湿性医疗技术的真正含义，及时换药，并且为病人换药时都能始终遵守无损伤原则，对比培训前后的规范化操作，P＜0.01（见表10-表12），两者差异有统计学意义。

结论：通过对广西金秀县的医疗卫生现况的调查，发现当地缺医少药，基层医院对中医药治疗技术的认知度不高，而中医药具有“简、便、廉、验”的优点，烧伤湿性医疗技术作为“十一五”国家科技支撑计划农村卫生适宜技术应用示范研究项目立项推广的适宜技术之一，本课题以金秀县为推广应用示范基地，进行烧伤湿性医疗技术在基层的应用规范化、标准化培训及适宜技术推广，通过此次的培训及调查为以后相关适宜技术在基层进行推广提供有益的借鉴经验。

关键词：农村医疗卫生现况；烧伤湿性医疗技术；规范化推广应用;调查研究Jinxiu County in Guangxi health status of rural and MEBT promote the use of standardized studyABSTRACTObjective:Jinxiu County of Guangxi, the status of medical research to understand the basic health service needs and demand for health services and socio-economic burden on individuals, and appropriate technology to rural health - MEBT grass-roots hospitals in Guangxi to promote the application of standardized study as an example, the analysis of popularization and application of appropriate technology in rural areas of the status quo, for the subsequent promotion of appropriate technology in rural areas and MEBT application at the grassroots level standardization research useful to explore.Methods: Survey methods used by investigators issued uniform. Part I: Investigation of Guangxi Jinxiu County grass-roots health services needs and demand for health services and socio-economic burden on individuals. Part II: survey before and after training MEBT to promote the application of the standardization.Results: Part I: Jinxiu County in Guangxi needs of rural medical and health status of the investigation:investigation of the Jinxiu Yao County People's Hospital and the hospital，Changdong，Zhongliang，Toupai，Tongmu 4 township hospitals and 16 village health ，paid surveys 1134，1051 valid questionnaires were recovered，the questionnaire an effective recovery rate of 92.7%. The survey: economic backwardness，the low level of education，as well as the inconvenience of traffic severely affected farmers in the region for medical treatment，at thesame time，the high cost of medical technology，the heavy financial burden on patients，hospital personnel lack of grass-roots level，township hospitals，lack of capital investment，serious shortage of the village health clinic for more attention to these factors，such as a medical treatment difficulties of farmers，the region has seriously affected the health status of farmers.Part II: MEBT promote the use of standardized surveys and training:Jinxiu County by more than 120 training, and achieved greater results, more than 120 trained staff to promote the basic grasp of the appropriate clinical application of medical technology. Before and after training in comparison MEBT demand found that physicians trained in the techniques of awareness was significantly higher than the pre-awareness training, P <0.01, statistically significant difference between the two, and in the need for learn the technology or the promotion of applications, before and after training there was no significant difference (P> 0.05, see Table 9). Before and after training in comparison MEBT operating standardized questionnaire found that the training of doctors can MEBT understand the true meaning of the dressing was changed in time, and when the dressing was changed for patients has always been able to comply with the principle of non-injury compared with before and after training the standardization of operation, P <0.01 (see Table 10 - Table 12), statistically significant difference between the two.Conclusion: Jinxiu County of Guangxi, the status of the medical and health survey, found that grass-roots medical conditions are relatively poor, grass-roots hospitals of traditional Chinese medicine treatment of awareness is not high, while Chinese medicine has "Jane, will, honesty,and examination of" the advantages MEBT as a national project to promote the project, the task to promote the use of County Jinxiu demonstration bases to MEBT for samples and MEBT application at the grassroots level standardization of training and appropriate technology promotion, training and through this investigation, identify the existing problems, the accumulation of experience, for the future related to the promotion of appropriate technology to provide useful experience.Key words: The status of rural health; MEBT;Promote the use of standardized；investigation and research引言农村医疗卫生直接关系到广大农民的身体健康和生命质量，是“三农问题”中的一个难点，是全面实现小康社会的重要内容之一。