地区医院在儿童疾病综合管理中的作用

为探讨地区医院在儿童疾病综合管理（ＩＭＣＩ）中的作用，回顾分析１９９５～１９９９年住院的ｌ～５岁的肺 炎、腹泻病、营养不良、麻疹和疟疾（５种疾病）。结果显示肺炎和腹泻病分别占５种疾病的７５．５０％和２１．４７％，营养 不良虽占１．７６％，但在３４３例并发病（同时患５种疾病中的２种以上时，第２种以上为并发病）中占６７．３５％。儿内科 住院的１～５岁患儿中，急性上呼吸道感染占３０．７７％，仅次于占３６．２０％的肺炎；病死１８例，首位死因是颅内感染。５ 种疾病的患儿分别占儿内科、传染病科同期住院总人数的１５．３６％和１．９０％，儿内科住院病例占同期门。急诊总人数的 １．１６％。提示除肺炎、腹泻病和营养不良外，本地区应把急性上呼吸道感染和颅内感染列入ＩＭＣＩ。地区医院在ＩＭＣＩ中 的作用是提高疾病的治愈率、提供师资培训和技术指导，应采取的措施是加强门、急诊工作和儿内科与传染病科的合作。

Study on the role played by regional hospital in integrated management of childhood illness

To investigate the role played by regional hospital in integrated management of childhood illness (IMCI), from Jan 1, 1995 to Dec 31, 1999, 2049 cases of pneumonia, diarrhea, malnutritin, measles and malaria (5 diseases), 1～5 years old, were hospitalized in podiatrics and department of infection; at the same time, 4251 cases of children, 1～5 years old, were hospitalized in podiatrics. The case reports were analyzed retrospctively. Of the 2049 cases, 75. 50% and 21. 47% were suffered from pneumonia and diarrhea respective. Only 1. 76% of the cases had malnutrition, which accounted for 67. 35 % in 343 cases of the 5 disease diagnosed as complications (If the children suffered from more then one kind of the 5 diseases, the diseases, except for the first one, were diagnosed as complications). Except for pneumonia, the most commonly encountered disease in the 4251 cases was acute upper respiratory tract infection (ARI), which accounted for 30. 77%. There were 18 cases died in the 4251 cases. The first cause of death was intracranial intection (7/18 cases). The cases of the 5 diseases accounted for 15. 36% and 1. 90% among the children hospitalized in podiatrics and department of infections. The hospitazlized cases accounted for 1. 16% of outpatients in podiatrics. In Guangdong province, in addition to pneumonia, diarrhea and malnutrition, ARI and intracranial infection should be included in IMCI. To raising the cure rate of diseases, training the teaching staff and providing technique are the duty of regional hospital taking part in IMCI. It is necessary to make the outpatient department more effective and strengthen the cooperation of podiatrics and infection department.