Abstract: Background The level and quality of diagnosis and treatment of Helicobacter pylori（Hp）infections in Shanghai's community health service Institutions is unclear，and there is a lack of systematic evaluation and monitoring. Objective To understand the current status of diagnosis，treatment and management of Helicobacter pylori（Hp）infection in community health centers in Shanghai，to evaluate the quality of diagnosis and treatment，and to explore the problems and improvement measures. Method A questionnaire was distributed to a total of 249 community health centers in 16 administrative districts of Shanghai and 3 875 general practitioners（GPs）working in the community health centers from May to June 2022 to investigate the standardization of prescriptions for the eradication of Hp infections in the community health centers，the detection of Hp infections，the provision of drugs for the eradication of Hp infections，the management of Hp infections，the difficulties of Hp infections in the treatment of Hp infections，as well as the knowledge of community-based GPs on the diagnosis and treatment of Hp infections. Result The result of the prescription eradication program for Hp infection in primary health care facilities in Shanghai was only 32.0 percent correct. The proportion of health service centers with the ability to conduct Hp infection testing in primary healthcare institutions in Shanghai is high，nearly 80%. Most of the community health service centers were able to equip the basic medicines needed for the eradication of Hp，but the rate of bismuth equipment was low，54.6%. The rate of Hp diagnosis and treatment standard supervision was 80.0%. The demand for the training of standardized diagnosis and treatment of Hp infections was high，accounting for 66.7%. The main difficulties in Hp infection diagnosis and treatment were incomplete drug provision，insufficient doctor's diagnosis and treatment ability and insufficient equipment. Community general practitioners do not have enough basic knowledge about the diagnosis and treatment of Hp infection. Conclusion The capacity to conduct Hp testing needs to be further strengthened in primary care organizations in Shanghai，especially in remote community health service centers，including the purchase of more Hp-related testing equipment and reagents，and the completion of related medications needed for the eradication of Hp. In addition，it is necessary to further strengthen the standardized diagnosis and treatment training of Hp infection for community health centers，improve the diagnosis and treatment ability of general practitioners on Hp infection，and at the same time，strengthen the supervision of Hp diagnosis and treatment standardization，so as to further improve the diagnosis and treatment ability of community general practitioners on Hp infection.

Key words: Helicobacter pylori, Community health service centers, Diagnosis and treatment standard, Quality of care, Systems management, Shanghai

摘要： 背景 上海市社区卫生服务机构对于幽门螺杆菌（Hp）感染的诊疗水平和质量尚不明确，缺乏系统的评价和监测。目的 了解上海市社区卫生服务机构对于Hp感染的诊疗及管理现状，评价其诊疗质量，并探讨其存在的问题和改进措施。方法 于2022年5—6月向上海市16个行政区共计249家社区卫生服务中心及3875名在社区卫生服务中心工作的全科医生发放调查问卷，调研社区卫生服务中心Hp感染根治处方规范化情况、Hp感染检测情况、Hp感染根治药物配备情况、Hp感染诊疗管理情况、Hp感染诊疗中困难问题，以及社区全科医生对Hp感染诊疗认知情况等。结果 上海基层医疗卫生机构Hp感染处方根治方案正确率仅为32.0%。上海基层医疗卫生机构中有能力开展Hp感染检测的卫生服务中心比例较高，近80%。大部分社区卫生服务中心能配备基本的根治Hp所需的药物，但铋剂配备率低，为54.6%。Hp诊疗规范督查率80.0%。Hp感染规范化诊疗培训需求较高，占66.7%。在Hp感染诊疗中，存在主要困难为药物配备不齐全、医生诊疗能力不足和设备不足。社区全科医生对Hp感染诊治相关基础知识掌握不足。结论 上海市各基层医疗卫生机构需进一步加强开展Hp检测的能力，特别是远郊社区卫生服务中心，包括增加购入Hp相关检测设备、试剂，完备Hp根治所需相关药物等。此外，需进一步加强对社区卫生服务中心Hp感染规范化诊疗培训，提高全科医师对Hp感染的诊疗能力，同时加强Hp诊疗规范督查，进一步提高社区全科医生Hp感染诊疗能力。

关键词: 幽门螺杆菌, 社区卫生服务中心, 诊疗规范, 诊疗质量, 系统管理, 上海市