目的：调查乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解程度并分析其影响因素，为进一步制定适且技术的培训方案提供参考依据。方法选取2012年9—11月参加湖南省儿童医院对湖南省14个地州市进行的儿科急诊适宜技术推广培训的1315家乡镇卫生院和1480名基层医务人员为调查对象。采用乡镇卫生院现况调查表、测试卷和个人信息表调查乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解情况，并分析其影响因素。结果共有1217家（92.5%）乡镇卫生院提交了完整合格的乡镇卫生院现况调查表。乡镇卫生院2011年排在前3位的儿科常见疾病是肺炎、腹泻、上呼吸道感染；744家（61.1%）乡镇卫生院有医务人员近3年参加过儿科相关知识的培训；971家（79.8%）乡镇卫生院认为开展小儿腹泻病液体疗法相关知识的培训适宜。共发放测试卷1267份，收回1173份，剔除个人信息填写不完整的测试卷，共有1095份有效测试卷，有效回收率为86.4%。基层医务人员对小儿腹泻病相关知识腹泻类型、1/2张液体的配制、脱水合并低血糖时补25%葡萄糖（ GS）的用量的了解率>50.0%，而对其他知识点的了解率却<50.0%。1095名基层医务人员中，仅有376名（34.3%）对小儿腹泻病液体疗法相关知识有所了解。不同执业类别、地区的基层医务人员对小儿腹泻病液体疗法相关知识了解率比较，差异有统计学意义（P<0.05）。多因素条件Logistic回归分析结果显示，从执业类别来看，以其他执业类别的基层医务人员为参照，儿科执业医师对小儿腹泻病液体疗法相关知识了解率高于其他执业类别（ P<0.05）；从不同地区来看，以湘南地区基层医务人员为参照，环长株潭城市群、大湘西地区基层医务人员对小儿腹泻病液体疗法相关知识了解率高于湘南地区（P<0.05）。结论乡镇卫生院基层医务人员对小儿腹泻病液体疗法相关知识的了解程度较低，了解水平参差不齐，考虑与乡镇卫生院儿科专科医生少、缺乏对小儿腹泻病的系统学习和知识更新有关，急需小儿腹泻病液体疗法相关知识的培训。%Objective To evaluate the knowing rate of relevant knowledge of fluid therapy on children with diarrhea by medical staff in the health centers in villages and towns and investigate its influencing factors,in order to provide references for the further formulation of training scheme. Methods From September to November 2012 , we enrolled 1 315 health centers in villages and towns and 1 480 grassroots medical staff in 14 autonomous prefectures and cities of Hunan Province that received the training of appropriate skills in pediatric emergency treatment organized by Hunan Children's Hospital. A questionnaire and a test paper about the status of health centers in villages and towns and a questionnaire about individual information were used to investigate the knowing rate of relevant knowledge of fluid therapy on children with diarrhea by medical staff in the health centers in villages and towns,and the influencing factors were explored. Results A total of 1 217(92. 5%)health centers in villages and towns submitted complete and qualified questionnaires about the status of health centers in villages and towns. In 2011,the first three common diseases with the largest prevalence in the health centers in villages and towns were pneumonia,diarrhea and upper respiratory infection;744(61. 1%)health centers in villages and towns had medical staff who had participated in relevant training about pediatric knowledge;971(79. 8%)health centers considered the training of relevant knowledge of fluid therapy on children with diarrhea is appropriate. A total of 1 267 test papers were distributed,and 1 173 papers were recollected. After the exclusion of incomplete test papers,1 095 effective test papers were returned with an effective returning rate of 86. 4%. The knowing rate of diarrhea type, the preparation of 1/2 isotonic liquid and the dosage of 25% glucose sugar in the case of dehydration complicated with hypoglycemia was more than 50. 0%. The knowing rates of other knowledge were all lower than 50. 0%. Among 1 095 grassroots medical staff,only 376(34. 3%)knew about the fluid therapy on children with diarrhea. The knowing rate of relevant knowledge of the fluid therapy varied significantly with types of job and different regions( P <0. 05 ) . Multiple conditional Logistic regression analysis showed that pediatric medical practitioners had higher(P<0. 05)knowing rate of fluid therapy on children with diarrhea than grassroots medical staff of other types of job;the grassroots medical staff in Changsha-Zhuzhou-Xiangtan city group and western Hunan Province had higher( P<0. 05 )knowing rate of fluid therapy on children with diarrhea than the grassroots medical staff in south Hunan Province. Conclusion Grassroots medical staff in the health centers in villages and towns have poor mastery of relevant knowledge of fluid therapy on children with diarrhea,and the mastery degree varies significantly from people to people. Due to a lack of professional pediatric doctors,a lack of systematic learning of diarrhea in children and the update of relevant knowledge, there is an urgent need for the training of relevant knowledge of fluid therapy on children with diarrhea.
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