中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
6期
400-402
,共3页
吴楠%张松荣%于普林%张秋桂%孙振球
吳楠%張鬆榮%于普林%張鞦桂%孫振毬
오남%장송영%우보림%장추계%손진구
良性前列腺增生%诊疗指南%横断面调查
良性前列腺增生%診療指南%橫斷麵調查
량성전렬선증생%진료지남%횡단면조사
Benign prostatic hyperplasia%Practice guideline%Cross sectional study
目的 了解中国良性前列腺增生(BPH)诊疗指南颁布后,老年科医生对指南遵照执行情况,对BPH患者进行诊断治疗情况.方法 采用横断面调查的方法,对中国南北两地区11个城市(北方4城市,南方7城市)33个三级甲等医院190名老年科医生老年科内科医生执行指南对BPH患者诊断治疗情况调查.结果 医生应答率为97.4%,医生在BPH诊断中普遍执行了指南推荐的检查项目,但不同检查项目采用率不同.病史询问,超声检查和尿常规检查医生采用率较高(>90.0%),尿流率检查采用率较低(31.2%),并且北方地区医生检查项目的 采用率普遍高于南方地区.对BPH患者进行了比较,南部地区患者平均年龄(76.8±6.7)岁大于北部地区患者(74.6±6.9)岁,南部地区患者前列腺体积均值为(39.5±18.8)ml小于北部地区患者(43.9±19.7)ml,南部地区患者最大尿流率均值为(9.9±2.9)ml/s大于北部地区患者(9.3±2.7)ml/s,南部地区患者IPSS评分均值为(13.0±7.3)低于北部地区患者(13.7±7.2),南部地区患者血清PSA(>4 ng/ml)比例为21.8%低于北部地区患者25.7%(均P<0.05).药物治疗是BPH治疗的首选方案,随着老年患者症状严重程度增加,药物治疗比例也随之上升,南方地区药物治疗比例由轻度症状患者中的61.9%上升到重度症状患者中的82.6%;北方地区轻度症状患者的54.6%上升到重度症状患者中的83.5%.结论 老年科医生普遍执行了BPH诊治指南.本研究结果可能会为指南今后的完善和更新提供参考.
目的 瞭解中國良性前列腺增生(BPH)診療指南頒佈後,老年科醫生對指南遵照執行情況,對BPH患者進行診斷治療情況.方法 採用橫斷麵調查的方法,對中國南北兩地區11箇城市(北方4城市,南方7城市)33箇三級甲等醫院190名老年科醫生老年科內科醫生執行指南對BPH患者診斷治療情況調查.結果 醫生應答率為97.4%,醫生在BPH診斷中普遍執行瞭指南推薦的檢查項目,但不同檢查項目採用率不同.病史詢問,超聲檢查和尿常規檢查醫生採用率較高(>90.0%),尿流率檢查採用率較低(31.2%),併且北方地區醫生檢查項目的 採用率普遍高于南方地區.對BPH患者進行瞭比較,南部地區患者平均年齡(76.8±6.7)歲大于北部地區患者(74.6±6.9)歲,南部地區患者前列腺體積均值為(39.5±18.8)ml小于北部地區患者(43.9±19.7)ml,南部地區患者最大尿流率均值為(9.9±2.9)ml/s大于北部地區患者(9.3±2.7)ml/s,南部地區患者IPSS評分均值為(13.0±7.3)低于北部地區患者(13.7±7.2),南部地區患者血清PSA(>4 ng/ml)比例為21.8%低于北部地區患者25.7%(均P<0.05).藥物治療是BPH治療的首選方案,隨著老年患者癥狀嚴重程度增加,藥物治療比例也隨之上升,南方地區藥物治療比例由輕度癥狀患者中的61.9%上升到重度癥狀患者中的82.6%;北方地區輕度癥狀患者的54.6%上升到重度癥狀患者中的83.5%.結論 老年科醫生普遍執行瞭BPH診治指南.本研究結果可能會為指南今後的完善和更新提供參攷.
목적 료해중국량성전렬선증생(BPH)진료지남반포후,노년과의생대지남준조집행정황,대BPH환자진행진단치료정황.방법 채용횡단면조사적방법,대중국남북량지구11개성시(북방4성시,남방7성시)33개삼급갑등의원190명노년과의생노년과내과의생집행지남대BPH환자진단치료정황조사.결과 의생응답솔위97.4%,의생재BPH진단중보편집행료지남추천적검사항목,단불동검사항목채용솔불동.병사순문,초성검사화뇨상규검사의생채용솔교고(>90.0%),뇨류솔검사채용솔교저(31.2%),병차북방지구의생검사항목적 채용솔보편고우남방지구.대BPH환자진행료비교,남부지구환자평균년령(76.8±6.7)세대우북부지구환자(74.6±6.9)세,남부지구환자전렬선체적균치위(39.5±18.8)ml소우북부지구환자(43.9±19.7)ml,남부지구환자최대뇨류솔균치위(9.9±2.9)ml/s대우북부지구환자(9.3±2.7)ml/s,남부지구환자IPSS평분균치위(13.0±7.3)저우북부지구환자(13.7±7.2),남부지구환자혈청PSA(>4 ng/ml)비례위21.8%저우북부지구환자25.7%(균P<0.05).약물치료시BPH치료적수선방안,수착노년환자증상엄중정도증가,약물치료비례야수지상승,남방지구약물치료비례유경도증상환자중적61.9%상승도중도증상환자중적82.6%;북방지구경도증상환자적54.6%상승도중도증상환자중적83.5%.결론 노년과의생보편집행료BPH진치지남.본연구결과가능회위지남금후적완선화경신제공삼고.
Objective To assess the diagnostic and therapeutic modality preferences of physician implementation of the Chinese Clinical Practice Guidelines for Benign Prostatic Hyperplasia (BPH) for geriatric BPH patients. Methods This cross-sectional survey was conducted at 33 medical centers located in 11 different cities in China (4 in north; 7 in south ). A total of 190 physicians were requested to record their preferences in diagnostic tests and treatment options for elderly BPH cases. Results The physician response rate was 97.4%. Respondents generally selected those practices consistent with the guidelines, but their preferences for recommended tests varied. The use of medical history, ultrasonography and urinalysis was higher (>90.0%) and that of uroflowmetry was lower (31.2%). In addition, the rate of use of recommended tests was higher among physicians in the north than those in the south. Drug therapy was the preferred treatment option. The proportion of drug treatment increased with the severity of symptoms in elder patients. In the south, the proportion of drug treatment in severe cases increased to 82.6% versus 61.9% in mild cases. In the north, the proportion of rug treatment in severe cases increased to 83.5% versus 54.6% in mild cases. Conclusion This study provides insights into the physician preferences of diagnosis and treatment. The physicians generally comply with the BPH clinical practice guidelines. It may also serve as a practical reference for updating and improving the Chinese Clinical Practice Guidelines for BPH.
