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目的调查和分析现阶段我国肺功能开展及近10年来的进展情况。方法通过问卷调查形式对全国已开展肺功能检查医院的肺功能检查工作人员进行临床应用情况调查,并与2002年的调查结果进行比较。结果参与本次调查的89家医院中三级医院占65.2%。肺通气功能检查(100%)及支气管舒张试验(86.5%)是最主要开展的检查项目。无一份问卷完整写出肺功能检查的质控标准。消毒传感器的占77.9%,消毒频率每周1次占41.2%,浸泡消毒的占75.4%。主要适应证为支气管哮喘(82.8%)及慢性阻塞性肺疾病(77.0%)。肺功能不良反应调查中,应答率为62.9%,其中以呼吸系统症状(咳嗽、喘息、声嘶)最常见,神经系统(头晕、指端麻木等)、心血管系统症状(心律失常、血压增高等)、消化系统症状(恶心、呕吐)次之,偶可见其他如腹痛、皮肤瘙痒、皮疹、下颌骨脱位、诱发其他疾病等二、三级医院常见不良反应的发生无明显差异(P>0.05)。肺功能培训情况此次调查的肺功能工作人员中,中、高级职称的占58.4%(52/89),65.2%(58/89)工作人员曾参加1个月或以上的技术培训,学员分布的培训单位达22个,开展肺功能培训的医院占24.7%。与2002年对比,受调查医院等级构成比无明显差异(P>0.05);项目开展也以通气功能检查为主。支气管激发试验中采用组织胺激发的医院百分比在2012年较2002年下降(41.3%对76%),而乙酰甲胆碱激发显著增加(54.3%对27.9%),差异均具有统计学意义(P<0.05)。仪器使用情况,2002年国产仪器占12.40%。2012年国产仪器使用0%。结论我国的肺功能临床应用有所发展,但肺功能质量控制、消毒、检查方法及继续教育等仍有待进一步提高。
Objective To investigate and analyze the current situation of pulmonary function in our country and its progress in the past 10 years. Methods A questionnaire survey was conducted to investigate the clinical application of pulmonary function tests in hospitals that have carried out pulmonary function tests in the country and compared with the results of the survey in 2002. Results Among the 89 hospitals in the survey, tertiary hospitals accounted for 65.2%. Lung function tests (100%) and bronchodilator tests (86.5%) are the most important inspection items. None of the questionnaires completed a complete set of quality control standards for pulmonary function tests. Sterilization sensors accounted for 77.9%, disinfection frequency once per week accounted for 41.2%, immersion disinfection accounted for 75.4%. The main indications for bronchial asthma (82.8%) and chronic obstructive pulmonary disease (77.0%). In the investigation of ADR, the response rate was 62.9%, of which respiratory symptoms (cough, wheezing and hoarseness) were the most common, nervous system (dizzy, numbness on the finger side), cardiovascular symptoms (arrhythmia, (Nausea, vomiting) followed by even see other secondary adverse reactions such as abdominal pain, skin itching, rash, mandibular dislocation, and other diseases induced by secondary and tertiary hospitals had no significant difference (P> 0.05 ). Pulmonary function training In this survey, 58.4% (52/89) of middle- and senior-level professional staff, 65.2% (58/89) of staff had participated in technical training of one month or more, and the distribution of trainees 22 training units and 24.7% of hospitals with lung function training. Compared with 2002, there was no significant difference (P> 0.05) in the constituent ratio of the hospitals under investigation. The project was mainly conducted on the basis of ventilatory function tests. The percentage of hospitals using histamine-inspired drugs in the bronchial provocation test decreased in 2012 compared with 2002 (41.3% vs. 76%) and methacholine challenge (54.3% vs. 27.9%) was significantly different (P <0.05). Instrument usage, domestic equipment accounted for 12.40% in 2002. 2012 domestic equipment use 0%. Conclusion The clinical application of pulmonary function in our country has been developed. However, the quality control, disinfection, examination methods and continuing education of pulmonary function still need to be further improved.