【摘要】 目的 了解四川省基层医疗卫生机构基本医疗功能开展情况，以便有针对性地采取措施，提高基层医疗卫生机构的服务能力。 方法 2008年8月采用自填式问卷调查的方法，对基层医疗卫生机构开展的基本医疗功能情况进行调查。 结果 基层医疗卫生机构提供的三类基本医疗功能（基本检查项目、常见病诊疗、家庭诊疗及转诊）总体情况不甚理想，基本检查项目开展情况社区卫生服务中心好于乡镇/街道卫生院。一级项目中除社区卫生服务中心转出服务开展比例达100%外，大部分医疗卫生机构一级、二级项目开展不全，社区卫生服务中心与乡镇/街道卫生院X线检查开展比例均在50%左右，常见病诊疗部分一级项目开展机构的比例不到30%。家庭诊疗及转诊二级项目两类机构开展比例均较低。 结论 基层医疗卫生机构提供的基本医疗功能特别是常见病诊疗项目有待加强。【Abstract】 Objective To understand the situation of basic medical services in primary medical institutions of Sichuan province so as to take related measures to improve the medical services in primary medical institutions. Methods We used self-administered questionnaires to investigate the basic medical services in primary medical institutions in August, 2008. Results The general situation of the three types of basic medical services (basic examination items, common disease diagnosis and treatment, family diagnosis and treatment and referrals) was not very good, but the development of basic examination items in the community health service center was better than that in villages and town hospitals or street service center. Among all kinds of first-grade medical health services, except for that the referral service in community health service center accounted for 100%, most of the first and second-grade medical health services were not fully developed. The proportion of X ray detection in community health service center and villages and town hospitals or street service center was about 50%, and the development of common disease diagnosis and treatment among the first grade medical health services accounted for only 30%. The proportion of family diagnosis and treatment and referrals was low. Conclusion The basic medial services in primary medical institutions should be strengthened, especially for the common disease diagnosis and treatment.
Objective To investigate the efficacy and safety of abdominal indwelling catheterization for the patients with large-volume ascites. Methods A total of 84 patients with liver cirrhosis complicated with large-volume ascites admitted in the first affiliated hospital of Xi’an Jiaotong University from January 2015 to December 2015 were retrospectively analyzed. Patients were divided into two groups, one was the puncture group and another was the catheterization group. The efficacy and safety were evaluated. Results Forty-four patients were enrolled in catheterization group, whereas forty patients were enrolled in puncture group. Symptoms associated with ascites had been eased and patients’ qualities of life had been improved in 2 weeks in each group. The tube fell out rate was 27.3% for patients in catheterization group. There was no operation related complications such as death, bleeding and intestinal perforation occurred. Either Child B stage or Child C stage, the dynamic changes of liver function and renal function in catheterization group were comparable to those in puncture group. No adverse event such as catheterization-related or puncture-related infection was observed. Conclusion Abdominal catheterization is effective and safe in management of large amount of ascites complicated with cirrhosis, however, the high rate of tube-fell-out should be paid more attention.