CAJ | 학술논문

目的了解新疆和田地区内科医师对支气管哮喘(简称哮喘)基本概念、治疗及管理的认知状况,为基层少数民族医师的培训提供依据.方法对和田地区26家不同级别医院共246名内科医师进行有关哮喘相关知识问卷调查,其中二级甲等医院1家,内科医师68名；二级乙等医院7家,内科医师122名；一级医院18家,内科医师56名.问题涉及:哮喘定义及哮喘炎症本质、哮喘的症状和诊断、哮喘的药物治疗和首选治疗方法、哮喘防治中存在的误区、全球哮喘防治创议(GINA)知晓情况及医院是否备有吸入激素药物等.结果对哮喘属气道慢性炎症及哮喘治疗方面如首选治疗方法、治疗目标及控制水平分级,回答正确率仅分别为11.8％、21.5％、8.5％和2.0％,且上述问题在二级与一级医院间差异有统计学意义(P＜0.05).对哮喘GINA知晓率、吸入方法的掌握及慢性疾病理念方面正确率分别为9.3％、13.8％和9.8％.二级甲等医院与二级乙等医院及一级乡镇医院相互间差异有统计学意义(P＜0.05).关于医院备有吸入支气管扩张剂或糖皮质激素方面,全地区七县一市共8家二级医院均备有药物(1家二级甲等地区医院、7家二级乙等县医院).一级乡镇医院均无短效支气管扩张剂和糖皮质激素吸入剂的备药.结论我国边疆基层医院,尤其是新疆南疆一、二级县乡镇医院对哮喘的认知防治管理方面存在较多问题,知识陈旧,对GINA知晓率低,不利于基层大量哮喘患者的治疗及管理,规范培训基层少数民族医务人员,使其掌握哮喘防治指南,从而有效指导哮喘患者是基层哮喘管理亟待解决的问题.
목적 료해신강화전지구내과의사대지기관효천(간칭효천)기본개념、치료급관리적인지상황,위기층소수민족의사적배훈제공의거.방법 대화전지구26가불동급별의원공246명내과의사진행유관효천상관지식문권조사,기중이급갑등의원1가,내과의사68명；이급을등의원7가,내과의사122명；일급의원18가,내과의사56명.문제섭급:효천정의급효천염증본질、효천적증상화진단、효천적약물치료화수선치료방법、효천방치중존재적오구、전구효천방치창의(GINA)지효정황급의원시부비유흡입격소약물등.결과 대효천속기도만성염증급효천치료방면여수선치료방법、치료목표급공제수평분급,회답정학솔부분별위11.8％、21.5％、8.5％화2.0％,차상술문제재이급여일급의원간차이유통계학의의(P＜0.05).대효천GINA지효솔、흡입방법적장악급만성질병이념방면정학솔분별위9.3％、13.8％화9.8％.이급갑등의원여이급을등의원급일급향진의원상호간차이유통계학의의(P＜0.05).관우의원비유흡입지기관확장제혹당피질격소방면,전지구칠현일시공8가이급의원균비유약물(1가이급갑등지구의원、7가이급을등현의원).일급향진의원균무단효지기관확장제화당피질격소흡입제적비약.결론 아국변강기층의원,우기시신강남강일、이급현향진의원대효천적인지방치관리방면존재교다문제,지식진구,대GINA지효솔저,불리우기층대량효천환자적치료급관리,규범배훈기층소수민족의무인원,사기장악효천방치지남,종이유효지도효천환자시기층효천관리극대해결적문제.
Objective To investigate the understanding levels of basic concept,treatment and management of bronchial asthma (asthma) among physicians in small towns around Xinjiang Hetian city so as to providea better training for them.Methods Analysis was made on the questionnaires about the knowledge of asthma filled in by 246 physicians from 26 small town hospitals around Hetian.Of all physicians investigated,there were 68 physicians from the two first class hospital,122 physicians from the two stage second grade hospital,and 56 physicians from 18 hospitals of grade 1,246 physicians were surveyed by questionnaire to estimate their knowledge about asthma,utility of medication and asthma control,firstlineused drugs and prognosis of asthma,awareness of GINA,etc.Results Among 246 patients,understanding the inflammatory nature of asthma accounted for 11.8％,the percentages for the correct answers that inhaling steroid is the first-line drug for controlling asthma,therapeutic target,control level,GINAS meaning,inhalation of master,chronic disease concept were 21.5 ％,8.5 ％,2.0 ％,9.3 ％,13.8 ％ and 9.8 ％ respectively among all physicians investigated.The percentages were significantly higher among the physicians from hospital of grade 2 than ones among those from hospital of grade 1 ( P ＜0.05).As for the question whether there is inhaling steroid prepared at hospital or not.The answer "yes"was in 8 hospital (all hospital of grade 2),but the answer " no" was in other hospitals including all hospitals of grade 1.Conclusions The borderland of our country basic level hospital,especially hospitals of grade 1 and 2 in South Xinjiang,there are still quite a lot of problems in understanding prevention,treatment and management of asthma,behaving as old or backward knowledge,lower awareness of GINA.This is unavailable for treatment and management of asthma.Therefore,standard training is badly needed for medical doctors from small town hospitals so that guideline for prevention and treatment of asthma can be mastered and effective guidance for asthma management can be achieved.