耳鼻喉科临床医师对阻塞性睡眠呼吸暂停低通气综合征的认知度调查

目的 归纳分析耳鼻喉科临床医师掌握阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的知识水平程度，及评价他们的自我从业态度。方法 采用美国OSAHS知识及态度问卷(OSAKA)作为基本模式，以邮寄方式对山东省41所公立医院的耳鼻喉科临床医师进行问卷调查。结果 回收有效问卷334份(占95.70%),全部知识条目的平均正确率为78%(74%±15%)。334位被调查的临床医师中，61.38%错误的认为“悬雍垂腭咽成型术可以治愈大多数OSAHS患者”；41.02%(0.41±0.49)能够正确回答“女性OSAHS患者可以仅仅只表现为疲乏”；50.90%(0.51±0.50)了解“成人睡眠中每小时呼吸暂停和/或低通气小于5次是正常的”；95%以上的被调查者认为OSAHS作为一类临床疾病、鉴别诊断患者是否有OSAHS风险，二者都具有重要意义；70%表示对OSAHS的诊断有信心，但仅有不足60%表示对OSAHS的治疗有信心；OSAHS相关知识总得分随着医师年龄及执业年限的增加而增高；随着耳鼻喉科临床医师对OSAHS疾病重要性的认识及诊疗自信心自我评价的增强而增高，即知识条目的回答正确率与临床医师对OSAHS疾病认知度之间呈线性正相关关系；耳鼻喉科临床医师对OSAHS发病机制的知识了解较为全面，正确率较高，对OSAHS治疗的相关知识了解较为有限，回答正确率最低。结论 耳鼻喉科临床医师对OSAHS的重要性有所认识，但对诊断、特别是相关治疗知识的掌握仍有待提高，通过加强继续教育等各种方式全面提高临床相关专业人员对OSAHS的认知程度，是提高诊疗水平的关键。

A survey to assess otolaryngologist′s knowledge and attitudes about obstructive sleep apnea hypopnea syndrome.

Objective To include and analyze the knowledge and attitudes about obstructive sleep apnea hypopnea syndrome(OSAHS)in the clinicians of departments of Otolaryngology. Methods A validated questionnaire from the USA, the “Obstructive Sleep Apnea Knowledge and Attitudes Questionnaire(OSAKA)” was used. The questionnaire was mailed to ENT doctors in 41 public hospitals in Shandong Province. Results 334 valid questionnaires(95.70%)were returned. The correction rate in average of all knowledge items were 78%. Among them, 61.38% clinicians mistakenly thought the“Uvulopalatopharyngoplasty is curative for the majority of patients with obstructive sleep apnea”. Only 41.02%(0.41±0.49)doctors could correctly answered the question“OSAHS in female can only present as fatigue”. About 50.90%(0.51±0.50) of responders knew “Less than five apneas or hypopneas per hour is normal in adults”. More scored on the knowledge OSAKA portion of pathophysiology, but were limited in OSAHS treatment. More than 95% of the participants stated that“As a clinical disorder OSAHS is important or extremely important and it is important to identify patients at risk for obstructive sleep apnea”. However, among them, only 70% felt confident in diagnosis and less than 60% felt confident in managing OSAHS patients. Individual knowledge items did not significantly differ by gender or by whether or not respondents had completed subspecialty training. There was a statistically significant correlation between the total knowledge scores with age and the years in practice. More knowledge was associated with more positive attitudes overall and older in age or longer years in practice. Conclusions The importance of OSAHS to clinicians of Otlaryngologic departments is well known. It is a key step to recommend that the knowledge and positive attitudes through more continuous education focusing on the diagnosis and treatment and identifying at risk for OSAHS are elevated.