龙淑珍 薛丽平 彭熙 刘华英 檀倩影 熊章龙

【摘要】 目的 了解广西乡镇卫生院常见病、常用临床操作技能及临床医师对临床操作技能的掌握情况，为提升乡镇卫生院临床医师基本医疗服务能力提供参考依据。

方法 于2019年6月至2020年6月，采用分层随机抽样法，对广西8个地市107家乡镇卫生院的596名临床医师开展问卷调查，调查内容包括：广西乡镇卫生院常见疾病及常用临床操作技能，广西乡镇卫生院临床医师对常用临床操作技能的掌握情况。

结果 广西乡镇卫生院常见疾病共54种，常用临床操作技能共52项。70%以上的广西乡镇卫生院临床医师对大部分基本诊断技能、外科操作技能、测量血压及吸氧术较为熟练，50%以上的临床医师对心电图、X线及CT结果判读、内科四大穿刺、插胃管术、新生儿窒息抢救、小儿气道异物处理、鼻腔冲洗、环甲膜穿刺术及电除颤术不熟练。

结论 提高临床医师的常见病诊疗水平和临床操作技能水平有助于提升乡镇卫生院基本医疗服务能力，为居民提供更优质的健康服务。

【关键词】 广西;乡镇卫生院;常见病;临床操作技能

中图分类号：R195   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.07.011

【Abstract】 Objective To investigate the common diseases， common clinical operating skills and clinicians' mastery of clinical operating skills in township health centers in Guangxi， so as to provide reference for improving the basic medical service ability of clinicians in township hospitals.

Methods A questionnaire survey was conducted among 596 clinicians from 107 township health centers in 8 cities of Guangxi from June 2019 to June 2020. The survey included common diseases， common clinical operating skills and the mastery of common clinical operating skills of clinicians in township health centers in Guangxi.

Results There were 54 kinds of common diseases and 52 common clinical operating skills in township hospitals in Guangxi. More than 70% clinicians in Guangxi township health centers were proficient in most of the basic diagnostic skills， surgical operating skills， blood pressure measurement and oxygen inhalation. However， more than 50% clinicians were not proficient in the interpretation of ECG， X-ray and CT results， four major punctures in internal medicine， gastric tube insertion， rescue of neonatal asphyxia， treatment of foreign body in airway in children， nasal irrigation， thyrocricocentesis and electric defibrillation.

Conclusion Improving the diagnosis and treatment level of common diseases and clinical operating skills of clinicians will help to improve the basic medical service ability of township hospitals and provide better health services for residents.

【Key words】 Guangxi; township health center; common disease; clinical operating skill

鄉镇卫生院是农村三级医疗卫生服务网络的枢纽环节，承担着基本医疗卫生服务、公共卫生服务与管理等多项职能。2015年国务院办公厅颁布实施了《关于推进分级诊疗制度建设的指导意见》以来，基层医疗机构的卫生服务量是有所增长的。调查显示，基层医疗机构医疗卫生服务能力薄弱，无法满足农村居民的医疗需求，广西分级诊疗制度实施效果不理想[1]。……