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目的了解北京农村地区基层医疗门诊就诊者的就诊原因和患病现状。方法在北京的8个郊区和2个县中随机选取2个郊区和1个县,在每个区和县中随机选取1个社区卫生服务中心(乡镇卫生院)及其下属社区卫生服务站或诊所,将所有于2008-04-25到这些中心和站/诊所就诊的全部就诊者作为本次调查的研究对象。结果在社区卫生服务中心就诊的1830例中有71.80%的为40岁以上;就诊原因的前三位分别是:循环系统、呼吸系统、全身性健康问题;在就诊者中慢性非传染性疾病患病率为44.43%,高血压患病率最高,为30.55%,其次是糖尿病为8.09%,其他为冠心病、脑卒中和骨关节病,分别为6.67%,4.75%,3.93%;多数患者(71.96%)仅患一种慢性病,181人(22.26%)同时患有两种及以上慢性病;在1199例接受药物治疗患者中,901例(75.15%)使用西药治疗,580例(48.37%)使用中药治疗,中西药使用率间差异有统计学意义(P<0.01);在就诊者中共71例(4.18%)被转诊。结论慢性病已经成为北京农村地区基层医疗服务中的主要健康问题,基层医生与城市中全科医生一样,提高农村地区基层医生对慢性非传染性疾病的诊疗和管理水平是十分必要的。
Objective To understand the reasons for the visits and the prevalence in primary care clinics in Beijing rural areas. Methods Two suburbs and one county were randomly selected in 8 suburbs and 2 counties of Beijing. One community health service center (township health center) and its affiliated community health service stations were randomly selected in each district and county or The clinic will include all the patients who visited these centers and stations / clinics from 2008-04-25 as the subjects of this survey. Results 71.80% of the 1830 cases visited by community health service centers were over 40 years of age. The top three reasons for the visits were circulatory system, respiratory system and general health problems. Among the patients with chronic non-communicable diseases The prevalence of hypertension was 30.55%, followed by that of diabetes was 8.09% and the others were coronary heart disease, stroke and osteoarthrosis, accounting for 6.67%, 4.75% and 3.93% respectively. The majority of patients ( 71.96%) had only one chronic disease and 181 (22.26%) had two or more chronic diseases at the same time. Of the 1,199 drug-treated patients, 901 (75.15%) were treated with western medicine and 580 (48.37% Chinese medicine treatment, the use of Chinese and Western medicine between the difference was statistically significant (P <0.01); 71 patients (4.18%) were referrals. Conclusion Chronic diseases have become the major health problems in primary medical services in rural areas of Beijing. Primary-level doctors, like general practitioners in urban areas, are necessary to improve the diagnosis and management of chronic non-communicable diseases in rural areas.