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目的调查不同地区和级别医院中不同科室临床医生参与骨质疏松管理工作现状,从医生角度了解目前防治骨质疏松的缺口,为学术界和卫生管理部门制定和完善骨质疏松防治策略提供依据。方法由参加调研医院自行选择本院参与骨质疏松诊疗相关科室的医生进行问卷调查,每个中心调查30~35人。结果来自11家三级甲等医院和6家二级医院的568名临床医生完成问卷,其中骨科和内分泌科医生最多。对所在医院是否开设骨质疏松门诊及是否有双能X线吸收检测法(dual-energy X-ray absorptiometry,DXA)测量骨密度,二级医院医生知晓率低于三级医院医生(二级医院知晓率分别为81.3%和90.2%,三级医院分别为89.1%和95.5%);骨科(96.9%)和内分泌科(98.2%)医生对本院是否有DXA的知晓率高于其他专科医生(89.4%)。各专业对钙剂和/或维生素D、选择性雌激素受体调节剂(selective estrogen receptor modulators,SERMs)知晓率差异无统计学意义(P<0.05),内分泌专业对于活性维生素D、双膦酸盐、降钙素类、雌激素类、锶盐知晓率高于其他专业,妇产科对于中药知晓率(54.5%)低于其他专业。骨质疏松工作的参与度调查显示,多数医生参与骨质疏松防治工作占全部业务工作的比例在30%以下,三级医院(16.5%)、骨科专业医生(21.9%)工作比例在30%以上者相对较高,每周诊治骨质疏松症患者例数较多者多见于骨科和内分泌科。结论中国骨质疏松防治事业在设备配置、医生知晓率和参与程度上均存在不足,同时获得省市17家医院临床医生对国内骨质疏松症患者管理提出的问题和建议,为我国骨质疏松防治策略制定和完善提供了一定的依据。
Objective To investigate the status of clinicians participating in the management of osteoporosis in different departments and hospitals in different regions and levels and to understand the current gap in prevention and treatment of osteoporosis from the perspective of doctors so as to provide basis for the formulation and improvement of prevention and treatment strategies for osteoporosis in academia and health administrations. Methods A questionnaire survey was conducted among doctors participating in the departments of diagnosis and treatment of osteoporosis who participated in the research hospital by themselves. Each center investigated 30 to 35 people. Results A total of 568 clinicians from 11 tertiary hospitals and 6 secondary hospitals completed the questionnaire, with the largest number of orthopedics and endocrinologists. Bone mineral density (BMD) was measured in the hospital where osteoporosis clinics were opened and if dual-energy X-ray absorptiometry (DXA) was used. The level of awareness of doctors in secondary hospitals was lower than that in tertiary hospitals 81.3% and 90.2% respectively, and 89.1% and 95.5% respectively in tertiary hospitals). The awareness rates of whether orthopedics (96.9%) and endocrinology (98.2%) doctors had DXA in our hospital were higher than those of other specialists 89.4%). There were no significant differences in the awareness rate of calcium and / or vitamin D and selective estrogen receptor modulators (SERMs) among different professions. Endocrine specialty had no significant difference on active vitamin D, bisphosphonic acid The awareness rate of salt, calcitonin, estrogen and strontium salt was higher than that of other majors. Obstetrics and gynecology’s awareness of traditional Chinese medicine was lower than that of other professions (54.5%). The survey on the participation of osteoporosis showed that the majority of doctors participated in the prevention and treatment of osteoporosis accounted for less than 30% of all the work, tertiary hospitals (16.5%), orthopedics (21.9%) work more than 30% Relatively high weekly weekly diagnosis and treatment of osteoporosis cases were more common in orthopedics and endocrinology. Conclusions China’s prevention and treatment of osteoporosis has its shortcomings in terms of equipment allocation, doctor’s awareness rate and participation level. At the same time, it has obtained the questions and suggestions on the management of osteoporosis patients from 17 hospitals in provinces and municipalities for our country’s osteoporosis Prevention and control strategies to develop and improve provide some basis.