| 摘要: |
| ［摘要］ 目的 了解广西县域医疗机构急诊资源配置、急症病种分布及医师急救培训需求，为提升基层急救能力、优化基层资源配置提供参考资料。方法 于2024年6月至2025年12月采用分层随机抽样法对广西14个地级市的121家县域医疗机构、948名医师开展问卷调查。其中18家医疗机构来自南宁、柳州、桂林，36家来自玉林、北海、钦州、百色，67家来自贵港、梧州、河池、崇左、防城港、来宾、贺州。调查内容包括县域医疗机构情况、调查对象基本情况、急救医疗设备配置情况、急救药品配置情况、常见急症、常用急救技能、急救知识培训需求、急救技能培训需求、基层医疗机构急救培训意愿。结果 121家受访医疗机构中，乡镇卫生院72家（59.50%），村卫生室27家（22.31%），县级医院10家（8.26%），社区医疗机构12家（9.92%）。共有62家（51.24%）受访医疗机构设有急危重症诊疗区。948名调查对象中，来自县级医院148人，社区医疗机构269人，乡镇卫生院364人，村卫生室167人。县域医疗机构医师整体学历及职称层次偏低。四类医疗机构中，县级医院急救医疗设备配置水平最高，其次是乡镇卫生院和社区医疗机构，村卫生室最低，差异有统计学意义（P<0.05）。县域医疗机构的基础通用急救设备配置率、基础急救药品配置率较高，CT仪、床边B超仪、血气分析仪、气道插管/切开包等精准诊疗及有创急救设备配置率普遍偏低，抗蛇毒血清、氯解磷定等解毒药物配置率低。县域医疗机构常见急症为循环系统急症、呼吸系统急症、消化系统急症、急性创伤、急性中毒等，常用急救技能以基础生命支持和基础创伤处置技能为主。县域医疗机构医师对诊疗知识及急救技能的培训需求与常见急症相匹配，普遍倾向于每半年进行1次培训、培训时长2～7 d以及在本单位开展培训。结论 广西各级县域医疗机构急诊医疗资源配置存在差异，医师急救培训需求与临床实际基本契合。针对性补齐资源短板，提升医师学历及职称层次，开展分层精准培训，有助于提升广西县域医疗机构急诊医疗服务水平。 |
| 关键词: 广西 县域医疗机构 急诊医疗 培训需求 |
| DOI：10.3969/j.issn.1674-3806.2026.08.15 |
| 分类号:R 19 |
| 基金项目:广西卫生健康委员会科研课题（编号：Z-A20241183） |
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| Current status and training needs for emergency medical services in county-level and below medical institutions in Guangxi: an investigation and analysis |
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Qin Huazhao, Long Shuzhen, Guo Jing, Zhang Xiaoling, Huang Qi
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School of Clinical Medicine, Guangxi Health Science College, Nanning 530000, China
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| Abstract: |
| ［Abstract］ Objective To understand the allocation of emergency resources, distribution of emergency diseases and emergency training needs of physicians in county-level and below medical institutions in Guangxi, and to provide reference for improving primary-level emergency care capacities and optimizing the resource allocation at the primary level. Methods From June 2024 to December 2025, a stratified random sampling method was applied to conduct a questionnaire survey involving 121 county-level and below medical institutions and 948 practicing physicians in 14 cities of Guangxi. Among the 121 institutions, 18 institutions were from Nanning, Liuzhou and Guilin; 36 institutions from Yulin, Beihai, Qinzhou and Baise; and 67 institutions from Guigang, Wuzhou, Hechi, Chongzuo, Fangchenggang, Laibin and Hezhou. The survey content included the baseline characteristics of the institutions and surveyed participants, the configuration of emergency medical equipment and medicines, common emergency diseases, first aid skills, demand for emergency knowledge and skills training, as well as training willingness for emergency care in primary medical institutions. Results Among the 121 medical institutions surveyed, 72 institutions were township health centers(59.50%); 27 institutions were village clinics(22.31%); 10 institutions were county-level hospitals(8.26%), and 12 institutions were community health service centers(9.92%). Among the 121 medical institutions surveyed, 62 institutions had areas for the diagnosis and treatment of emergency and critical diseases. A total of 948 physicians were included in the survey, including 148 physicians from county-level hospitals, 269 physicians from community health service centers, 364 physicians from township health centers, and 167 from village clinics. Overall, the participating physicians exhibited relatively low educational attainment and professional title levels. The configuration level of emergency medical equipment varied among these 4 types of primary-level institutions, with the highest level in county-level hospitals, followed by township health centers and community health service centers, and the lowest level in village clinics, and the difference was significant(P<0.05). The allocation rates of basic general emergency equipment and basic emergency drugs in county-level medical and below institutions were relatively high. However, the allocation rates of precise diagnosis and treatment equipments and invasive emergency equipments such as CT scanners, bedside B-ultrasound devices, blood gas analyzers, tracheal intubation/tracheostomy kits were generally low, and the allocation rates of specific antidotes such as antivenom and pralidoxime chloride were also low. The common emergency and critical diseases that could be managed by county-level and below medical institutions included acute circulatory system emergency disease, respiratory emergency disease, acute digestive system emergency disease, acute trauma and acute poisoning. The commonly used first aid skills mainly consisted of basic life support and basic trauma treatment skills. The training needs of physicians in the county-level and below medical institutions for diagnosis and treatment knowledge as well as first aid skills were matched with common emergency and critical diseases. These physicians generally tended to receive training once every six months, with a training duration of 2-7 days, and to have the training conducted at their own institutions. Conclusion Significant disparities exist in the allocation of emergency medical resources among county-level and below medical institutions in Guangxi, and the emergency training needs of physicians are basically consistent with clinical practice. Targeted measures to address resource gaps, enhancing physicians′ academic degrees and professional titles, and conducting tiered precise training help improve the level of emergency medical services in county-level and below medical institutions in Guangxi. |
| Key words: Guangxi county-level and below medical institutions emergency medical services training needs |
