□ 项海青 XIANG Hai-qing

Based on the practices of some hospitals in Hangzhou, the author discussed on the functional space of the hospital fever clinic from eight aspects and put forward some suggestions. The first aspect was about the hierarchical management of three levels and five grades. The second aspect was about the decentralized and centralized building layout. The third aspect was about the flat and compound structure. The fourth aspect was about the double channels and buffer room, and space layout for observation function of braille type, fishbone type, and parallel type.The fifth aspect was about the significance of corridors in "three zones and two channels". The sixth aspect was about the setting of pharmacy,laboratory test, registration and charging, disinfection, and other related functional spaces. The seventh aspect was about backup space preservation, including the outdoor emergency rescue site, the backup ward buildings, and the reconstruction and expansion land. The last aspect was about the prefabricated construction, decorative materials and the improvement of the artistic quality.

通过发热门诊对发热患者进行诊疗是我国在2003年严重急性呼吸综合征(SARS)疫情期间探索出来的传染病预防与控制工作模式，发热门诊已成为医疗机构应对突发公共卫生事件的第一道防线[1-2]，在疫情防控过程中发挥了关键性的作用[3]。

新冠肺炎疫情发生以后，至今仅国家层面发布的发热门诊相关文件就有9个，应该说医院发热门诊建筑功能空间的具体规定要求越来越清晰。但是，为了预防与控制传染性疾病的传播，阻断传染性气溶胶的传播，各医疗机构可以结合各自医院特点，实施传染病管理的工程控制，应采取传染病患者占用空间污染的最小化措施，即采取有效手段隔离传染源，使其污染范围最小化[4]。笔者结合杭州实践，就医院发热门诊系统的分级分类、建筑布局、结构类型、诊室和病房流程、“三区两通道”设置、相关功能区域设置、后备空间、建造方式和装饰材料等建筑功能空间问题提出自己看法，供同道斧正。

分级分类管理

目前，尚未对发热门诊进行分级分类管理，但现实中很有必要，只有这样才能精细监管。笔者认为发热门诊可分为三级五等。省级和设区的市级传染病定点医院的三级甲等综合性医院/中医院或三级传染病医院的发热门诊，所在的感染性疾病楼总建筑面积在16000m2以上的，为三级甲等发热门诊；县(市、区)级传染病定点医院的二级甲等以上综合性医院或传染病医院的发热门诊，所在的感染性疾病楼总建筑面积在10000m2以上的，为三级乙等发热门诊；……