陕西省地区级城市中心医院支气管哮喘相关科室医师的调查分析

目的 调查陕西省地区级城市中心医院支气管哮喘(简称哮喘)相关科室医师对哮喘知识的了解程度,旨在评估前期哮喘协作组在医师教育方面的成果,为陕西省下一步的医师教育工作部署提供理论依据.方法 在陕西省的6个地区级城市中各选取一所三级医院,以问卷调查的形式了解2007年10月至12月门诊医师对哮喘知识的知晓程度,涉及专业包括呼吸内科、综合内科、儿科和急诊科.调查内容包括哮喘发病机制、防治知识、2006版全球哮喘防治刨议(global initiative for asthma,GINA)及相关组织结构等.结果 收回调查问卷187份,呼吸内科、综合内科、急诊科和儿科分别占29.9%、23.0%、26.7%和20.3%.①在对哮喘相关组织的了解方面:58.9%-62.5%的呼吸内科医师对哮喘相关指导机构很清楚,远远高于其他专业;但仍有10.7%的呼吸内科医师不知道GINA的含义.知道世界哮喘日的医师已占到87.6%;②在2006版GINA内容方面:认识到哮喘的气道慢性炎症本质的医师为69.9%.其中呼吸内科医师最高为78.6%,综合内科医师最低为55.8%.了解按控制水平分类的呼吸内科医师为69.6%.远远高于其他专科.54.8%～75.0%的医师认识到吸入糖皮质激素(inhaled corticosteroid,ICS)在哮喘防治牟的重要地位.但只有7.1%、42.9%的呼吸内科医师清楚哮喘控制测试、短效β2受体激动剂在哮喘管理中与救治中的作用.清楚长效β2受体激动剂需与ICS联用的医师只有37.8%.了解白三烯受体拮抗剂为控制药物的已达52.0%～76.4%.仍有51.9%的医师认为医院自产的过敏原提取物能够用于临床脱敏治疗.只有35.3%的医师知道肺功能检测能做为确诊哮喘的重要依据.12.3%的医师认为口服是最佳的给药途径.20.9%、19.3%的医师表示不会用或没见过粉吸入装置.42.2%的医师表示近3年曾参加过哮喘知识新进展的教育或研讨会.54.5%的医师表示为每位接诊的哮喘患者制定了长期用药方案及随访计划.结论 通过调查了解了陕西省地区级城市中心医院医师对哮喘知识的掌握程度.总体来看,呼吸内科医师的掌握程度高于其他专科,但距离普及规范化治疗理念还任重而道远.这些资料将为联盟在西部地区的医师教育工作提供参考.

Survey among doctors related with bronchial asthma patients in central hospitals of region level cities in Shaanxi province

Objective To evaluate the situation of grasping bronchial asthma(asthma) knowledge ofdoctors related with asthma patients in central hospitals of region level cities in Shaanxi province, and toappraise the effect of doctor education in order to provide evidence for the next step of education. MethodsSix hospitals were selected from six region level cities, where questionnaire survey was completed in thedorctors from the department of respiratory medicine, internal medicine, emergency or pediatrics. Thequestionnaire involved pathogenesy, prevention, treatment and advencement of global initiative for asthma(GINA). Results 187 doctors completed the qusetionnaire,and the ratio of every speciality was 29.9%,23.0%,26.7% and 20.3%, respectively. 58.9%-62.5% dorctors in respiratory knew the organization ofasthma clearly and the ratio was very higher than that in other spciality. But 10.7% dorctors did not knowthe significance of GINA. World Asthma Day was known in 87.6%. 69.9% doctors understood thepathogenesy of slow airway inflammation, while the highest ratio was 78.6% in repiralogy and the lowestone was 55.8% in internal medcine. Repiratory doctor knew the classification of asthma according tocontroled level most clearly in all people. 54.8%-75.0% doctors knew the importance of inhaledcorticosteroid (ICS)in therapy. But the effect of asthma control test and stort-acting β2-agonist wasunderstood only by 7.1% and 42.9% respiratory doctors. 37.8% doctors knew the use of long-actingβ2-agonist should be combined with ICS. 52.0%-76.4% doctors knew the blocker of leukotriene receptorwas control medcine. 51.9% docors thought that sensitinogen extractive produced by himself could be uesedin asthma patients. Only 35.3% doctors knew the significence of pulmonary function in diagnosing asthma.12.3% doctors admitted oral administration was the optimal way. 20.9% and 19.3% doctors expressed theycould not use or did not see the equipment of inhaled powder. Only 42.2% doctors accepted the education onasthma in recent three years, and 54.5% doctors formulated the long-time management plan for eachout-patient. Conclusions The situation of grasping asthma knowledge of doctors in central hospitals ofregion level cities in Shaanxi province is investigated throuth survey. In all,the level of learning new GINA inrespiratory doctors is higer than that in other speciality. However, more work need be done to make thestandard threatment popular. The information of survey will offer help for the plan of doctor education inwestern area of the country.