2020 年第 11 期 第 15 卷

不断完善的健康服务体系，助力西藏居民全面小康——西藏农牧区医疗卫生体系发展成效及展望

The continuously improving health service system has contributed to prosperity for all of Tibet residents—The development status and expectation of the medical and health system in Tibet′s farming and pastoral areas

作者：扎西达娃1,2扎西德吉1,2拉巴桑珠1,2旺珍3多庆4

英文作者：Zhaxidawa12 Zhaxideji12 Labasangzhu12 Wangzhen3 Duoqing4

单位：1西藏大学医学院，拉萨850000；2西藏大学中国藏学研究所（珠峰研究院），拉萨850000；3西藏大学理学院，拉萨850000；4西藏自治区社会科学院，拉萨850000

英文单位：1Tibet University Medical College Lhasa 850000 China; 2Center of Tibetan Studies (Everest Research Institute) Tibet University Lhasa 850000 China; 3Tibet University School of Science Lhasa 850000 China; 4Tibetan Academy of Social Sciences Lhasa 850000 China e:AR-SA'>—The development status and expectation of the medical and health system in Tibet′s farming and pastoral areas

关键词：全民健康；全面小康；西藏卫生体系；西藏人均寿命；西藏妇幼健康

英文关键词：Healthforall;Prosperityforall;Tibethealthsystem；LifeexpectancyinTibet;Women′sandchildren′shealthinTibet

• 摘要：

• 西藏自治区平均海拔在4 000米以上，现有人口340多万，近70%的人口分布在以农牧业为主的高海拔地区。由于高寒、缺氧、低气压、强辐射、气候干燥等特殊自然环境对人体健康的影响，以及历史原因，高原病、传染病、地方病等的患病率较高，这些疾患成为影响西藏整体人口健康素质的重要因素之一。党和政府历来高度重视西藏自治区卫生事业发展及人民健康水平的提高，特别是近十多年来，国家卫生健康委员会会同相关单位大力推进医疗人才“组团式”援藏，极大地改善了农牧区医疗服务水平。通过开设培训班对当地基层医院的医生进行培训，着力提高当地医生的医疗救治水平，对当地卫生人才队伍的建设起到了推动作用。逐步建立和健全了农牧区医疗管理的相关办法，推进了医疗保障制度的改革，有效保障了农牧区居民的基本医疗需求。孕产妇死亡率和婴儿死亡率由2012年的176.12/10万和24.84‰已分别下降至2019年的63.68/10万、8.9‰。地方病得到了有效地控制，人口平均预期寿命由和平解放前的35.5岁提高到2012年的67岁，2019年西藏自治区卫生健康委员会公布的数据显示，西藏人口平均预期寿命提高至70.6岁。据西藏自治区2019年卫生健康统计年报显示，全自治区各级医疗机构数由2012年的1 352个增加到2019年的1 642个，床位数由8 838张增加到17 073张；卫生技术人员由10 082人增加到20 662人。在这些数字的背后，彰显了西藏医疗卫生体系的不断完善和发展，最终推动全民健康全面小康的目标实现。

• The Tibet Autonomous Region has an average altitude of more than 4 000 meters, and currently has a population of more than 3.4 million. Nearly 70% of the population is located in high-altitude areas dominated by agriculture and animal husbandry. Due to the special impact of high cold, hypoxia, low air pressure, strong radiation, and dry climate  on human health as well as historical reasons, the morbidities such as plateau diseases, infectious diseases and endemic diseases are relatively high. It became one of the important risk factors to affect the health qualities. The party and the government have always attached great importance to the development of health services in the Tibet Autonomous Region and the improvement of people′s health. In recent years, the National Health Commission, in conjunction with relevant units, has vigorously promoted the "group-type" of medical personnel to assist Tibet, which has greatly improved the level of medical services in rural and pastoral areas. Training courses were set up to train local doctors in primary hospitals, so as to improve the treatment levels and promote the construction of local health personnel teams. The relevant measures for medical management in farming and pastoral areas have been gradually established and improved, the reform of the medical security system has been promoted, and the needs of residents living in farming and pastoral areas for basic medical services have been effectively guaranteed. The mortalities of puerperal pregnant women and infants have decreased from 176.12/100 000 and 24.84‰ in 2012 to 63.68/100 000 and 8.9‰ in 2019, respectively. Endemic diseases have been effectively controlled, and the average life expectancy of the population has increased from 33.5 years before peaceful liberation to 67 years in 2012,and has risen to 70.6 years by 2019. According to Tibet Autonomous Region annual report of health statistics in 2019, from 2012 to 2019, the number of medical institutions at all levels in the autonomous region have increased from 1 352 to 1 642, the number of hospital beds has increased from 8 838 to 17 073, and the number of hygienic personnel has increased from 10 082 to 20 662. Behind these figures, it highlights the continuous improvement and development of the medical and health system in the Tibet Autonomous Region, and ultimately promotes to achieve the goal of health for all and prosperity for all.