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目的探索影响都江堰市综合性医院与乡镇(社区)卫生院犬伤门诊就诊情况的原因,为犬伤的规范化诊疗提供参考依据。方法采取回顾性观察研究的方法,通过调取都江堰市疾病预防控制中心数据库,收集2012年1月-2015年12月期间都江堰市行政区域内所有设有犬伤门诊的医疗机构每年收治的犬伤患者资料。并于2016年3月采用调查问卷的方式,收集两种级别医疗机构犬伤患者的就诊满意度以及犬伤门诊工作人员对犬伤暴露伤口处置方法的知晓率。比较上述指标间的差异,寻找可能影响都江堰市犬伤门诊分级诊疗的原因。结果全市共有1家综合性医院和27家乡镇(社区)卫生院设有犬伤门诊并全部参与此次研究。研究期间,综合性医院每年收治的犬伤患者总数量及其占全年所有犬伤患者的比例逐年递减,尤其Ⅱ级犬伤暴露患者数量明显减少。而乡镇(社区)卫生院收治犬伤患者的总数量及其占全市所有犬伤患者的比例则呈逐年递增趋势,其中Ⅱ级和Ⅲ级犬伤暴露患者的数量于2015年达峰值,分别为1 944例(44.10%)和1 248例(28.31%)。满意度和知晓率调查结果提示,综合性医院的该两项指标均均高于乡镇(社区)卫生院,两者之间差异有统计学意义(P<0.05)。结论都江堰市综合性医院和乡镇(社区)卫生院犬伤门诊患者就诊总量变化基本符合分级诊疗要求,但后者需进一步加强犬伤门诊工作人员的培训,规范犬伤处置流程,最终提高患者就诊满意度。
Objective To explore the causes of canine outpatient visits in general hospitals and township (community) hospitals in Dujiangyan and to provide reference for the standardization of dog injuries. Methods By retrospectively observing and studying the methods, by retrieving the database of Dujiangyan Center for Disease Control and Prevention, we collected the data of dog breeds treated annually by medical institutions with dog out-patient clinics in the administrative area of Dujiangyan City from January 2012 to December 2015. Patient information. In March 2016, a questionnaire was used to survey the satisfaction of two groups of patients with canine wounded in medical institutions and the awareness rate of dog wounded clinic staff in handling wounds exposed to dog wounds. Compare the differences between the above indicators to find out the reasons that may affect the grading diagnosis and treatment of canine outpatient clinics in Dujiangyan City. Results There were 1 general hospitals and 27 township (community) hospitals in the city with dogs outpatient clinics and all involved in this study. During the study period, the total number of canine injuries and the percentage of all cases of canine injuries admitted to the general hospitals decreased year by year. In particular, the number of patients with grade Ⅱ canine injuries was significantly decreased. However, the total number of dog victims admitted to township (community) hospitals and the percentage of all dogs with canine injuries in the township (community) hospitals increased year by year. The number of patients with grade Ⅱ and Ⅲ canine injuries reached their peak in 2015 1 944 cases (44.10%) and 1 248 cases (28.31%). Satisfaction and awareness of the survey results suggest that the two indicators were higher in general hospitals than township (community) hospitals, the difference was statistically significant (P <0.05). Conclusion The total number of outpatients with canine outpatient visits in Dujiangyan General Hospital and township (community) hospitals basically meets the requirements of grading treatment. However, the latter needs to further strengthen the training of dogs in outpatient clinics, standardize the procedures of treatment of canine injuries and eventually improve the patients Satisfaction