论文部分内容阅读
目的了解南京市内科医生对慢性阻塞性肺疾病(COPD)认知水平及COPD的治疗现状,为今后开展针对性继续教育提供依据。方法 2009年6～12月,采用分层随机抽样的方法对南京市部分医院内科医生进行问卷调查,主要内容包括COPD的症状与诊断认知水平、轻中重度及稳定期患者的治疗和药物选择情况等,对稳定期COPD患者是否需要治疗的认知状况以及内科医生自身吸烟情况。结果将139个调查对象分为三级医院呼吸专科医生组(70人)和二级及以下医院内科医生组(69人),两组医生在年龄、性别、职称等方面差异均无统计学意义。诊断COPD时两组医生都会询问患者慢性咳嗽和气流受阻情况,但呼吸专科医生会更多了解吸烟史、COPD家族史等。肺功能检查对诊断COPD有非常重要的意义,调查发现呼吸专科医生对此都有认知,但二级及以下医院只有85.5%的内科医生认知到肺功能各项指标诊断COPD的临床意义,两组都需要进一步了解。而对于轻中重度COPD患者的治疗,两组医生所开处方无统计学差异,但对于祛痰药评价过高,应用频率也较高。两组医生吸烟比例分别为11.4%和17.4%。结论目前南京市呼吸专科医生和二级及以下医院内科医生对于COPD的认知水平均较高,重视稳定期的治疗,两组医生对COPD诊断和治疗认知上差异无统计学意义,但是对COPD的用药及长期防控干预还有一定差距,医生自身仍存在一定比例的吸烟。
Objective To understand the cognition of chronic obstructive pulmonary disease (COPD) and the treatment of COPD by physicians in Nanjing, and to provide the basis for carrying out targeted continuing education in the future. Methods From June to December 2009, stratified random sampling method was used to conduct questionnaire survey among some hospitals in Nanjing. The main contents include the level of cognitive impairment and diagnosis of COPD, the treatment and drug selection in patients with mild to moderate and severe COPD Conditions, etc., whether the need for treatment of stable COPD patients cognitive status and physicians own smoking. Results 139 subjects were divided into three levels of hospital respiratory specialist group (70) and two level of hospital physician group (69), the two groups of doctors in terms of age, gender, job title and other differences were not statistically significant . Both groups of doctors inquired about chronic cough and airflow obstruction when diagnosing COPD, but respiratory specialists would know more about smoking history and family history of COPD. Pulmonary function tests are very important for the diagnosis of COPD. The survey found that all respiratory specialists knew this, but only 85.5% of physicians in secondary and lower hospitals recognized the clinical significance of various indexes of lung function in diagnosing COPD. Both groups need further information. For the treatment of mild to moderate-severe COPD patients, the two groups of doctors prescribe no significant difference, but for the expectorant expectorant is too high, the application frequency is higher. Two groups of doctors smoking rates were 11.4% and 17.4%. Conclusions At present, the level of cognition of COPD is higher among respiratory specialists in Nanjing and physicians in secondary hospitals and below. The treatment of stable COPD patients is of great importance. There is no significant difference between the two groups in the diagnosis and treatment of COPD. However, COPD medication and long-term prevention and control intervention there is a certain gap, the doctor himself still exists a certain percentage of smoking.