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目的:了解临床工作实践中支气管哮喘防治指南(GINA方案)在基层医院的实施情况及遇到的问题并提出今后解决办法。方法:对门诊及病房住院的患者进行调查研究,采用统一设计的表格、问卷及必要的检查,对结果进行统计和分析。结果:正规治疗与非正规治疗的患者的花费情况具有明显差别,差异具有统计学意义。当地91.2%支气管哮喘曾经误诊为慢性支气管炎。治疗不规范,曾吸入激素治疗的占全部患者的18.1%,曾经和正在口服私人配制的平喘药物(粉剂或胶囊)的占65.8%;病情复发时给予输液、利用抗生素治疗的占73.6%;给予大剂量激素、不规范治疗(包括长期用激素治疗、不逐渐减量)治疗的78.7%;结论:当地哮喘治疗还存在很多问题,形式非常严峻,有待于进一步加大GINA治疗方案的推广。
Objective: To understand the clinical practice of bronchial asthma guidelines (GINA program) in the implementation of the grass-roots hospitals and the problems encountered and put forward solutions to the future. Methods: The outpatient and inpatient hospital patients were investigated, the use of unified design forms, questionnaires and the necessary checks, the results of statistical and analysis. Results: There was a significant difference in the cost of treatment between regular and non-regular patients, the difference was statistically significant. 91.2% of local bronchial asthma has been misdiagnosed as chronic bronchitis. 18.1% of all patients who had taken inhaled corticosteroids, 65.8% of those who had oral administration of anti-asthmatic medications (powders or capsules) formulated orally and 73.6% received antibiotics; 78.7% of the patients treated with high-dose hormones and non-standard treatment (including long-term hormone therapy without gradual reduction). Conclusion: There are still many problems in the treatment of local asthma. The form is very serious and the promotion of GINA treatment needs to be further intensified.