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Article(id=1241023931147153837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202405218, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1715443200000, receivedDateStr=2024-05-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812762295, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812762295, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812762295, creator=13701087609, updateTime=1773812762295, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=503, endPage=507, ext={EN=ArticleExt(id=1241023931436560828, articleId=1241023931147153837, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Survey on the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in 78 public hospitals in Sichuan Province, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in public hospitals at different levels in Sichuan Province, and to provide suggestions for further promoting the early diagnosis and treatment projects of upper gastrointestinal cancers and improving the screening quality.

Methods

A questionnaire survey was conducted on public hospitals in Sichuan Province that undertook opportunistic screening for upper gastrointestinal cancers in 2023, and the diagnosis and treatment capabilities, hardware capabilities and staffing situations of upper gastrointestinal cancer early diagnosis and treatment in hospitals at different levels were compared and analyzed.

Results

The average annual total number of gastroscopy diagnosis and treatment in 78 hospitals was 8 400.82 person-times. In total 96.15% of the hospitals had an independent endoscopy department, and 87.18% of the hospitals had an independent pathology department. On average, there were 3.29 endoscopy hosts, 10.19 gastroscopes, with an average of 6.97 endoscopy physicians, 4.14 pathologists and 5.41 endoscopy nurses. The higher the hospital level, the higher the relevant indicators of diagnosis and treatment capabilities, hardware capabilities and staffing.

Conclusion

The overall situation of resource allocation for early diagnosis and treatment in public hospitals in Sichuan Province is good, but it is necessary to strengthen the construction of pathology departments and focus on optimizing the resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in secondary hospitals.

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目的

调查四川省不同级别公立医院上消化道癌早诊早治资源配置现状，为进一步推广上消化道癌早诊早治项目，提高筛查质量提供建议。

方法

对四川省2023年承担上消化道癌机会性筛查的公立医院进行问卷调查，比较分析不同级别医院上消化道癌早诊早治诊疗能力、硬件能力和人员配置情况等。

结果

78家医院平均年胃镜诊疗总量为8 400.82人次，96.15%的医院拥有独立的内镜科，87.18%的医院拥有独立的病理科，平均拥有内镜主机3.29台，胃镜10.19条，平均配备内镜医师6.97名，病理医师4.14名，内镜护士5.41名。医院级别越高，诊疗能力、硬件能力和人员情况相关指标越高。

结论

四川省公立医院早诊早治资源配置整体情况良好，但需要加强病理科室建设，重点关注二级医院上消化道癌早诊早治资源配置优化问题。

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乔良，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=haCzEuG1WwRDJ2qOfyD/fQ==, magXml=OS6gMhP/By0kSBs7t+UrWw==, pdfUrl=null, pdf=1zjq6NuOzkWAFkO+pOtW+A==, pdfFileSize=677987, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=EUOBffecMjomECEF/4bmUA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=+9MdWTdLfOeJOVYYFtczwA==, mapNumber=null, authorCompany=null, fund=null, authors=

钟志刚（1995—），男，硕士，助理研究员，研究方向：肿瘤预防与控制

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钟志刚（1995—），男，硕士，助理研究员，研究方向：肿瘤预防与控制

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钟志刚（1995—），男，硕士，助理研究员，研究方向：肿瘤预防与控制

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注：A、B、C分别表示内镜医师职称、学历及年龄分布情况；D、E、F分别表示病理医师职称、学历及年龄分布情况；G、H、I分别表示内镜护士职称、学历及年龄分布情况。

, figureFileSmall=F/ENprJZ0ooD2Jf8D+BYJQ==, figureFileBig=EUOBffecMjomECEF/4bmUA==, tableContent=null), ArticleFig(id=1241023941125403503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=EN, label=Table 1, caption=

Early diagnosis and treatment capabilities of upper gastrointestinal cancer in hospitals of different levels in Sichuan Province［（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
诊疗能力三甲三乙二甲/二乙合计χ2/Z/F值P 值
年胃镜诊疗总量（人次）12 994.11±9 601.905 207.04±2354.652 206.54±1186.778 400.82±8097.0633.930<0.001
是否开展ESD33/37(89.19)21/28(75.00)5/13(38.46)59/78(75.64)13.4450.001
是否开展EMR37/37(100.00)26/28(92.86)11/13(84.62)74/78(94.87)4.9770.049
是否开展碘染35/37(94.59)26/28(92.86)7/13(53.85)68/78(87.18)11.5090.002
是否开展靛胭脂染色31/37(83.78)18/28(64.29)4/13(30.77)53/78(67.95)12.6840.001
是否开展NBI36/37(97.30)27/28(96.43)11/13(84.62)74/78(94.87)2.9610.218
是否具备独立诊断能力37/37(100.00)28/28(100.00)10/13(76.92)75/78(96.15)8.9350.004
), ArticleFig(id=1241023941255426941, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=CN, label=表1, caption=

四川省不同等级医院上消化道癌早诊早治诊疗能力情况［（），n（%）］

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诊疗能力三甲三乙二甲/二乙合计χ2/Z/F值P 值
年胃镜诊疗总量（人次）12 994.11±9 601.905 207.04±2354.652 206.54±1186.778 400.82±8097.0633.930<0.001
是否开展ESD33/37(89.19)21/28(75.00)5/13(38.46)59/78(75.64)13.4450.001
是否开展EMR37/37(100.00)26/28(92.86)11/13(84.62)74/78(94.87)4.9770.049
是否开展碘染35/37(94.59)26/28(92.86)7/13(53.85)68/78(87.18)11.5090.002
是否开展靛胭脂染色31/37(83.78)18/28(64.29)4/13(30.77)53/78(67.95)12.6840.001
是否开展NBI36/37(97.30)27/28(96.43)11/13(84.62)74/78(94.87)2.9610.218
是否具备独立诊断能力37/37(100.00)28/28(100.00)10/13(76.92)75/78(96.15)8.9350.004
), ArticleFig(id=1241023941381256070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=EN, label=Table 2, caption=

Hardware capabilities for early diagnosis and treatment of upper gastrointestinal cancer in hospitals of different levels in Sichuan Province[（n（%）,（）］

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硬件能力三甲三乙二甲/二乙合计χ2/Z/F值P值
是否拥有独立的内镜科36/37(97.30)27/28(96.43)12/13(92.31)75/78(96.15)1.2300.571
是否拥有独立的病理科35/37(94.59)24/28(85.71)9/13(69.23)68/78(87.18)5.2760.054
内镜主机台数（台）4.11±1.742.82±0.982.00±0.413.29±1.5726.183<0.001
胃镜条数（条）14.97±10.196.86±3.153.77±1.7910.19±8.6324.359<0.001
), ArticleFig(id=1241023941490307988, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=CN, label=表2, caption=

四川省不同等级医院上消化道癌早诊早治硬件能力情况[（n（%）,（）］

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硬件能力三甲三乙二甲/二乙合计χ2/Z/F值P值
是否拥有独立的内镜科36/37(97.30)27/28(96.43)12/13(92.31)75/78(96.15)1.2300.571
是否拥有独立的病理科35/37(94.59)24/28(85.71)9/13(69.23)68/78(87.18)5.2760.054
内镜主机台数（台）4.11±1.742.82±0.982.00±0.413.29±1.5726.183<0.001
胃镜条数（条）14.97±10.196.86±3.153.77±1.7910.19±8.6324.359<0.001
), ArticleFig(id=1241023941637108643, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=EN, label=Table 3, caption=

Early diagnosis and treatment of upper gastrointestinal cancer in hospitals of different levels in Sichuan Province（）

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人员情况三甲三乙二甲/二乙合计F值P值
内镜医师数9.11±4.995.71±3.213.62±1.566.97±4.5018.119<0.001
病理医师数6.27±4.182.75±1.511.08±0.864.14±3.6829.735<0.001
内镜护士数7.32±5.834.43±2.382.08±0.765.41±4.6823.097<0.001
), ArticleFig(id=1241023941804880819, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023931147153837, language=CN, label=表3, caption=

四川省不同等级医院上消化道癌早诊早治人员情况（）

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人员情况三甲三乙二甲/二乙合计F值P值
内镜医师数9.11±4.995.71±3.213.62±1.566.97±4.5018.119<0.001
病理医师数6.27±4.182.75±1.511.08±0.864.14±3.6829.735<0.001
内镜护士数7.32±5.834.43±2.382.08±0.765.41±4.6823.097<0.001
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四川省78家公立医院上消化道癌早诊早治资源配置现状调查
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钟志刚 1 , 蒲星月 2 , 李丽娜 1 , 刘潇霞 1 , 马婧 1 , 赵锐 3 , 许佳豪 1 , 乔良 1
现代预防医学 | 健康与社会行为 2025,52(3): 503-507
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现代预防医学 | 健康与社会行为 2025, 52(3): 503-507
四川省78家公立医院上消化道癌早诊早治资源配置现状调查
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钟志刚1, 蒲星月2, 李丽娜1, 刘潇霞1, 马婧1, 赵锐3, 许佳豪1, 乔良1
作者信息
  • 1.四川省肿瘤医院·研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，四川省癌症防治中心办公室（预防部），四川 成都 610041
  • 2.四川省妇幼保健院组织人事部
  • 3.四川省肿瘤医院·研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，内镜科

    • 钟志刚（1995—），男，硕士，助理研究员，研究方向：肿瘤预防与控制

通讯作者:

乔良，E-mail:
Survey on the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in 78 public hospitals in Sichuan Province
Zhi-gang ZHONG1, Xing-yue PU2, Li-na LI1, Xiao-xia LIU1, Jing MA1, Rui ZHAO3, Jia-hao XU1, Liang QIAO1
Affiliations
  • Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Cancer, Office (Prevention Department) of Sichuan Cancer Center,Chengdu, Sichuan 610041, China
出版时间: 2025-02-10 doi: 10.20043/j.cnki.MPM.202405218
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摘要
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目的

调查四川省不同级别公立医院上消化道癌早诊早治资源配置现状，为进一步推广上消化道癌早诊早治项目，提高筛查质量提供建议。

方法

对四川省2023年承担上消化道癌机会性筛查的公立医院进行问卷调查，比较分析不同级别医院上消化道癌早诊早治诊疗能力、硬件能力和人员配置情况等。

结果

78家医院平均年胃镜诊疗总量为8 400.82人次，96.15%的医院拥有独立的内镜科，87.18%的医院拥有独立的病理科，平均拥有内镜主机3.29台，胃镜10.19条，平均配备内镜医师6.97名，病理医师4.14名，内镜护士5.41名。医院级别越高，诊疗能力、硬件能力和人员情况相关指标越高。

结论

四川省公立医院早诊早治资源配置整体情况良好，但需要加强病理科室建设，重点关注二级医院上消化道癌早诊早治资源配置优化问题。

上消化道癌  /  早诊早治  /  资源配置  /  四川省
Objective

To investigate the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in public hospitals at different levels in Sichuan Province, and to provide suggestions for further promoting the early diagnosis and treatment projects of upper gastrointestinal cancers and improving the screening quality.

Methods

A questionnaire survey was conducted on public hospitals in Sichuan Province that undertook opportunistic screening for upper gastrointestinal cancers in 2023, and the diagnosis and treatment capabilities, hardware capabilities and staffing situations of upper gastrointestinal cancer early diagnosis and treatment in hospitals at different levels were compared and analyzed.

Results

The average annual total number of gastroscopy diagnosis and treatment in 78 hospitals was 8 400.82 person-times. In total 96.15% of the hospitals had an independent endoscopy department, and 87.18% of the hospitals had an independent pathology department. On average, there were 3.29 endoscopy hosts, 10.19 gastroscopes, with an average of 6.97 endoscopy physicians, 4.14 pathologists and 5.41 endoscopy nurses. The higher the hospital level, the higher the relevant indicators of diagnosis and treatment capabilities, hardware capabilities and staffing.

Conclusion

The overall situation of resource allocation for early diagnosis and treatment in public hospitals in Sichuan Province is good, but it is necessary to strengthen the construction of pathology departments and focus on optimizing the resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in secondary hospitals.

Upper gastrointestinal cancer  /  Early diagnosis and treatment  /  Resource allocation  /  Sichuan Province
钟志刚, 蒲星月, 李丽娜, 刘潇霞, 马婧, 赵锐, 许佳豪, 乔良. 四川省78家公立医院上消化道癌早诊早治资源配置现状调查. 现代预防医学, 2025 , 52 (3) : 503 -507 . DOI: 10.20043/j.cnki.MPM.202405218
Zhi-gang ZHONG, Xing-yue PU, Li-na LI, Xiao-xia LIU, Jing MA, Rui ZHAO, Jia-hao XU, Liang QIAO. Survey on the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in 78 public hospitals in Sichuan Province[J]. Modern Preventive Medicine, 2025 , 52 (3) : 503 -507 . DOI: 10.20043/j.cnki.MPM.202405218
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受不良饮食习惯、生物感染等因素影响，全球80%以上的上消化道癌（食管癌、贲门癌、胃癌）发病和死亡发生在欠发达地区[1]。四川省作为经济欠发达的西部省份，食管癌和胃癌发病及死亡顺位均排在四川省恶性肿瘤发病和死亡前列[2-3]，严重威胁四川地区居民健康。“医防融合”通过医疗服务与公共卫生服务的协同供给，提升医疗卫生资源使用效率，减少居民健康问题，从以往“以疾病为中心”向“以健康为中心”的服务模式转变[4-5]。上消化道癌早诊早治项目将癌症二级预防与治疗进行有效融合与衔接，从而实现上消化道癌早发现、早诊断、早治疗。相关研究指出，内镜筛查能发现更多的上消化道早期癌及癌前病变，可使人群上消化道癌累积发病率降低23%，累积死亡率降低57%，早期上消化道癌能在内镜获得根治性治疗，五年生存率可达90%以上[6]。随着我国上消化道癌早诊早治项目的持续推进，消化内镜设备的不断更新，消化内镜诊疗技术不断提高，人们对癌症筛查与早诊早治的认识转变，胃镜诊疗数量逐年增加[7]。然而，在诊疗数量快速增长的同时，诊疗质量不容乐观。相关研究指出，不同地区、不同级别医院，由于技术、设备和人员等卫生资源配置的差异，导致诊疗质量参差不齐[8]。本研究基于四川省农村上消化道癌机会性筛查早诊早治项目开展地区，分析不同级别公立医院上消化道癌早诊早治资源配置现状，为进一步推广上消化道癌早诊早治项目，提高筛查质量提供政策建议。
1　对象与方法
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1.1　研究对象
2023年10—11月，对四川省18个市（州）88家癌症早诊早治（农村）上消化道癌机会性筛查项目单位进行问卷调查，78家医院接受了调查，医院应答率为88.64%（78/88），最终收到问卷78份，问卷有效率为100%。
1.2　调查方法
采用自制问卷，通过问卷星连接进行线上调查，调查内容主要包括：（1）医院基本情况：机构类型、机构等级等；（2）诊疗能力：包括年胃镜诊疗总量、内镜黏膜下剥离术（endoscopic submucosal dissection,ESD）开展情况、内镜黏膜切除术（endoscopic mucosal resection,EMR）开展情况、染色（包括碘染、靛胭脂和内镜窄带成像技术（narrow band imaging,NBI））开展情况等；（3）硬件能力：是否拥有独立的内镜科、是否拥有独立的病理科、是否具备独立诊断能力、消化内镜数量等；（4）人员情况：内镜医师、病理医师和内镜护士的数量、职称、学历和年龄等。
1.3　统计分析
采用SPSS 21.0软件进行统计分析。计量资料的描述以（）表示，组间比较采用单因素方差分析；计数资料的描述以率或百分比表示，组间比较采用χ2检验或Fisher确切概率法。所有统计检验均为双侧检验，α=0.05。
2　结果
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2.1　基本情况
调查的78家医院中，有67家综合医院，占85.90%，11家中医医院，占14.10%；县区级医院54家，占69.23%，市（州）级及以上医院24家，占30.77%；三甲医院37家，占47.44%，三乙医院28家，占35.90%，二甲/二乙医院13家，占16.67%。
2.2　不同级别医院诊疗能力情况
本次调查的78家医院平均年胃镜诊疗总量为8 400.82人次，75.64%的医院开展了ESD，94.87%医院开展了EMR，87.18%的医院开展了碘染，67.95%的医院开展了靛胭脂染色，94.87%的医院开展了NBI，96.15%的医院具备独立诊断能力。从不同医院级别来看，三甲医院的平均年胃镜诊疗总量为12 994.11例，高于三乙的5 207.04例和二甲/二乙的2 206.54例，差异有统计学意义（F=33.930，P<0.001）；开展了ESD的三甲医院占89.19%，高于三乙的75.00%，远高于二甲/二乙的38.46%，差异有统计学意义（χ2=13.445，P= 0.001）；所有三甲医院开展了EMR，三乙医院为92.86%，二甲/二乙医院为84.62%，差异有统计学意义（Z=4.977，P=0.049）。94.59%的三甲医院、92.86%的三乙医院和53.85%的二甲/二乙医院开展了碘染，差异有统计学意义（Z=11.509，P=0.002）；开展了靛胭脂染色的三甲医院占83.78%，高于三乙的64.29%，和二甲/二乙的30.77%，差异有统计学意义（χ2= 12.684，P=0.001）；97.30%的三甲医院、96.43%的三乙医院和84.62%的二甲/二乙医院均开展了NBI，差异无统计学意义（Z=2.961，P=0.218）；三甲及三乙医院均具备独立诊断能力，76.92%的二甲/二乙医院具备独立诊断能力，差异有统计学意义（Z=8.935，P= 0.004）。见表1。
2.3　不同级别医院硬件能力情况
调查的医院中，96.15%的医院拥有独立的内镜科，87.18%的医院拥有独立的病理科，平均拥有内镜主机台数为3.29台，胃镜条数为10.19条。从不同医院级别来看，拥有独立内镜科的三甲医院占97.30%，高于三乙的96.43%和二甲/二乙的92.31%，差异无统计学意义（Z=1.230，P=0.571）；拥有独立病理科的三甲医院占94.59%，高于三乙的85.71%和二甲/二乙的69.23%，差异无统计学意义（Z=5.276，P=0.054）；配备的内镜主机数量，三甲为4.11台，高于三乙的2.82台和二甲/二乙的2.00台，差异有统计学意义（F=26.183，P<0.001）；关于胃镜条数，三甲医院平均拥有14.97条，三乙医院平均拥有6.86条，二甲/二乙医院平均拥有3.77条，差异有统计学意义（F=24.359，P<0.001）。见表2。
2.4　不同级别医院人员配置情况
从人员配备来看，调查医院平均配备内镜医师6.97名，病理医师4.14名，内镜护士5.41名。从不同级别医院来看，无论哪一类人员，均是三甲医院人员>三乙>二甲/二乙，差异有统计学意义（内镜医师数：F=18.119，P<0.001；病理医师数：F=29.735，P<0.001；内镜护士数：F=23.097，P<0.001）。见表3。
从人员结构来看，内镜医师以副高及以上职称（43.27%）和中级职称（42.91%）为主，68.68%的学历为大学本科，35～39岁年龄阶段占比为29.23%，其次是<35岁这一年龄段，占比为26.47%；病理医师以中级职称为主，占38.24%，副高及以上职称和初级（含未定级）的各约占30%，大学本科学历占比最高，为63.50%，<35岁年龄段人数最多，占37.91%；内镜护士以中级（48.94%）和初级（含未定级）（42.08%）职称为主，大学本科学历占比最高，为69.36%，<35岁年龄段人数最多，为51.66%。从不同级别来看，三级医院各类人员的中、高级职称占比更高（病理人员除外）、硕士及以上学历占比更高；年龄分布上，内镜医师各年龄段分布较为均匀，但二级医院高年龄段占比较高，病理人员和内镜护士的年龄分布趋势比较相似，以<35岁和35～39岁两个年龄段为主，但二级医院年龄分布更加年轻化，三级医院高年龄段占比较高。见图1。
3　讨论
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癌症筛查和早诊早治是实现降低癌症负担的重要健康管理策略，是癌症防控中非常重要的一环[9]。胃镜检查是上消化道癌筛查与早诊早治的重要手段，能提高上消化道癌检出率，增加患者生存空间，提高生活质量，减轻患者家庭经济负担[10]。我国从2005年起就以中央财政转移支付的形式，在农村高发区开展以人群为基础的上消化道癌筛查和早诊早治工作，取得了一定成效。为了进一步扩大我国上消化道癌的筛查及早诊早治工作的覆盖面，促进我国肿瘤防治的可持续发展，上消化道癌机会性筛查项目逐步受到重视与关注[11]。
本研究依托四川省上消化道癌机会性筛查项目单位开展调查，了解四川省上消化道癌机会性筛查早诊早治项目承担医院资源配置现状，从诊疗能力、硬件能力和人员配置情况进行全面评估。从诊疗能力来看，四川省公立医院年平均胃镜诊疗总量达8 400.82人次，75.64%的医院开展了ESD，94.87%医院开展了EMR，87.18%的医院开展了碘染，67.95%的医院开展了靛胭脂染色，相关指标远高于辽宁省[12]、陕西省[13]；从硬件能力来看，四川省96.15%的医院拥有独立的内镜科，87.18%的医院拥有独立的病理科，低于辽宁省的100%[14]，独立的内镜科和病理科是开展上消化道癌机会性筛查的基本条件，提示四川省项目单位需要进一步加强内镜和病理科室建设，而尤其是病理科，仅85.71%的三乙医院建设有病理科，二级医院仅69.23%的医院有病理科。病理是肿瘤诊断的金标准，直接影响上消化道癌筛查和早诊早治效果[15]。四川省平均拥有内镜主机台数为3.29台，胃镜条数为10.19条，优于辽宁省[12]的设备配置情况；从人员配置来看，四川省本次调查医院平均配备内镜医师6.97名，高于辽宁省[12]、贵州省[16]内镜医生的配备数量。从人员构成来看，内镜医师中级以上职称占比为86.18%，大学本科及以上学历占比为97.25%，均高于全国平均水平（分别为75.68%和93.20%）[17]，病理医师中级以上职称占比为69.71%，大学本科及以上学历占比为90.80%，均高于全国平均水平（分别为61.58%和85.51%）[18]，提示四川省上消化道癌早诊早治项目技术人员整体素质较强，具有较高文化程度和专业技能水平。
四川省上消化道癌机会性筛查早诊早治资源整体配置情况良好，但不同级别医院差异较大。无论是诊疗能力水平、硬件配置、人员配置情况来看，总体趋势为三级医院优于二级医院，研究结果与相关研究一致[12-13，19]，这主要是因为我国卫生资源分布不均，优势资源多集中在大型三级医院[20]。基层医院作为上消化道癌机会性筛查的主力军，上消化道癌早诊早治能力建设有待加强。一方面，需要通过合理规范使用中央财政经费、积极争取地方财政经费等措施加强科室建设和设备配置；另一方面，卫生人力资源是卫生资源配置的重要组成部分，要加强人才培养和梯队建设，引进高学历人才，促进整体实力提升，最终实现全省范围内上消化道癌早诊早治资源公平可及，确保群众受益。
基金
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  • 四川省科技厅重点研发项目(2023YFG0148)
  • 四川省自然科学基金(2022NSFSC0640)
  • 四川省医学科研课题计划(S22004)
  • 四川省科普培训项目(2023JDKP0034)
  • 成都市科技局技术创新研发项目(2022-YF05-02005-SN)
  • 川北医学院2024年度四川省基层卫生事业发展研究中心资助项目(SWFZ24-Y-54)
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2025年第52卷第3期
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doi: 10.20043/j.cnki.MPM.202405218
  • 接收时间：2024-05-12
  • 首发时间：2026-03-18
  • 出版时间：2025-02-10
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  • 收稿日期：2024-05-12
基金
四川省科技厅重点研发项目(2023YFG0148)
四川省自然科学基金(2022NSFSC0640)
四川省医学科研课题计划(S22004)
四川省科普培训项目(2023JDKP0034)
成都市科技局技术创新研发项目(2022-YF05-02005-SN)
川北医学院2024年度四川省基层卫生事业发展研究中心资助项目(SWFZ24-Y-54)
作者信息
    1.四川省肿瘤医院·研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，四川省癌症防治中心办公室（预防部），四川 成都 610041
    2.四川省妇幼保健院组织人事部
    3.四川省肿瘤医院·研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，内镜科

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乔良，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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