目的 调查中国泌尿外科医师管理良性前列腺增生(BPH)患者的现行认识和实践模式与中华医学会泌尿外科学分会(Chinese Urological Association,CUA)2011版《良性前列腺增生诊断治疗指南》间的差距,为改善BPH患者管理水平提供依据. 方法 2012年9-11月利用CUA组织顾问委员会制定的中国泌尿外科医师问卷对CUA注册的、每周至少20 h临床实践的泌尿外科医师的基本信息、对BPH的认识、对疑似BPH患者的诊断、对BPH患者的治疗及随访BPH患者的实际操作5个方面进行调查.共发放调查问卷7 500份,收回问卷4 897份(应答率为65.3％),剔除86份无效问卷及37份重复录入问卷,共4 774份有效问卷被纳入分析.调查对象平均年龄为(39.9±9.2)岁.来自三级医院3 802/4 692名(81.0％),二级医院878/4 692名(18.7％),其他医院12/4 692名(0.3％).来自东北地区455/4 759名(9.6％),华北地区812/4 759名(17.1％),华东地区1696/4759名(35.6％),中南/华南地区869/4 759名(18.2％),西南地区634/4 759名(13.3％),西北地区295/4 759名(6.2％).工作年限≤10年1 835/4 194名(43.8％),11 ～20年1 505/4 194名(35.9％),21 ～30年705/4 194名(16.8％),≥31年149/4 194名(3.5％).学历为博士研究生732/4 629名(15.8％),硕士研究生1 729/4 629名(37.4％),大学本科2 067/4 629名(44.7％),大学专科101/4 629名(2.1％).职称为主任医师834/4 575名(18.2％),副主任医师1 371/4 575名(30.0％),主治医师1 605/4 575名(35.1％),住院医师765/4 575名(16.7％). 结果 医师对BPH临床进展的主要表现和临床进展风险预测因素的认识与指南的符合率分别为43.4％ (2 023/4 665)和10.2％(477/4 660).对疑似BPH患者的初始评估方法与指南的符合率为20.2％(845/4 181),且存在显著的地区差异,不符合率由高至低依次为东北地区66.5％ (290/436),中南/华南地区64.7％ (556/859),西北地区55.6％(158/284),华东地区55.1％(922/1 672),华北地区54.7％(435/795),西南地区48.0％ (296/617).医师对BPH的主要治疗目的与指南的符合率为4.9％(229/4 666),对观察等待条件的认识与指南的符合率为22.5％(1 051/4 674),对BPH患者手术治疗适应证的认识与指南的符合率为94.6％(4410/4663).93.4％ (4388/4699)的医师认可5-α还原酶抑制剂在缩小前列腺体积方面的疗效.医师对观察等待患者、药物治疗患者随访时的检查与指南符合率仅7.8％ (355/4 531)和8.4％(373/4 432),对术后患者随访时的检查与指南符合率为44.8％(2 105/4 702). 结论 泌尿外科医师对CUA 2011版《良性前列腺增生诊断治疗指南》掌握水平较低,有必要开展针对特定群体或特定内容的培训.
目的 調查中國泌尿外科醫師管理良性前列腺增生(BPH)患者的現行認識和實踐模式與中華醫學會泌尿外科學分會(Chinese Urological Association,CUA)2011版《良性前列腺增生診斷治療指南》間的差距,為改善BPH患者管理水平提供依據. 方法 2012年9-11月利用CUA組織顧問委員會製定的中國泌尿外科醫師問捲對CUA註冊的、每週至少20 h臨床實踐的泌尿外科醫師的基本信息、對BPH的認識、對疑似BPH患者的診斷、對BPH患者的治療及隨訪BPH患者的實際操作5箇方麵進行調查.共髮放調查問捲7 500份,收迴問捲4 897份(應答率為65.3％),剔除86份無效問捲及37份重複錄入問捲,共4 774份有效問捲被納入分析.調查對象平均年齡為(39.9±9.2)歲.來自三級醫院3 802/4 692名(81.0％),二級醫院878/4 692名(18.7％),其他醫院12/4 692名(0.3％).來自東北地區455/4 759名(9.6％),華北地區812/4 759名(17.1％),華東地區1696/4759名(35.6％),中南/華南地區869/4 759名(18.2％),西南地區634/4 759名(13.3％),西北地區295/4 759名(6.2％).工作年限≤10年1 835/4 194名(43.8％),11 ～20年1 505/4 194名(35.9％),21 ～30年705/4 194名(16.8％),≥31年149/4 194名(3.5％).學歷為博士研究生732/4 629名(15.8％),碩士研究生1 729/4 629名(37.4％),大學本科2 067/4 629名(44.7％),大學專科101/4 629名(2.1％).職稱為主任醫師834/4 575名(18.2％),副主任醫師1 371/4 575名(30.0％),主治醫師1 605/4 575名(35.1％),住院醫師765/4 575名(16.7％). 結果 醫師對BPH臨床進展的主要錶現和臨床進展風險預測因素的認識與指南的符閤率分彆為43.4％ (2 023/4 665)和10.2％(477/4 660).對疑似BPH患者的初始評估方法與指南的符閤率為20.2％(845/4 181),且存在顯著的地區差異,不符閤率由高至低依次為東北地區66.5％ (290/436),中南/華南地區64.7％ (556/859),西北地區55.6％(158/284),華東地區55.1％(922/1 672),華北地區54.7％(435/795),西南地區48.0％ (296/617).醫師對BPH的主要治療目的與指南的符閤率為4.9％(229/4 666),對觀察等待條件的認識與指南的符閤率為22.5％(1 051/4 674),對BPH患者手術治療適應證的認識與指南的符閤率為94.6％(4410/4663).93.4％ (4388/4699)的醫師認可5-α還原酶抑製劑在縮小前列腺體積方麵的療效.醫師對觀察等待患者、藥物治療患者隨訪時的檢查與指南符閤率僅7.8％ (355/4 531)和8.4％(373/4 432),對術後患者隨訪時的檢查與指南符閤率為44.8％(2 105/4 702). 結論 泌尿外科醫師對CUA 2011版《良性前列腺增生診斷治療指南》掌握水平較低,有必要開展針對特定群體或特定內容的培訓.
목적 조사중국비뇨외과의사관리량성전렬선증생(BPH)환자적현행인식화실천모식여중화의학회비뇨외과학분회(Chinese Urological Association,CUA)2011판《량성전렬선증생진단치료지남》간적차거,위개선BPH환자관리수평제공의거. 방법 2012년9-11월이용CUA조직고문위원회제정적중국비뇨외과의사문권대CUA주책적、매주지소20 h림상실천적비뇨외과의사적기본신식、대BPH적인식、대의사BPH환자적진단、대BPH환자적치료급수방BPH환자적실제조작5개방면진행조사.공발방조사문권7 500빈,수회문권4 897빈(응답솔위65.3％),척제86빈무효문권급37빈중복록입문권,공4 774빈유효문권피납입분석.조사대상평균년령위(39.9±9.2)세.래자삼급의원3 802/4 692명(81.0％),이급의원878/4 692명(18.7％),기타의원12/4 692명(0.3％).래자동북지구455/4 759명(9.6％),화북지구812/4 759명(17.1％),화동지구1696/4759명(35.6％),중남/화남지구869/4 759명(18.2％),서남지구634/4 759명(13.3％),서북지구295/4 759명(6.2％).공작년한≤10년1 835/4 194명(43.8％),11 ～20년1 505/4 194명(35.9％),21 ～30년705/4 194명(16.8％),≥31년149/4 194명(3.5％).학력위박사연구생732/4 629명(15.8％),석사연구생1 729/4 629명(37.4％),대학본과2 067/4 629명(44.7％),대학전과101/4 629명(2.1％).직칭위주임의사834/4 575명(18.2％),부주임의사1 371/4 575명(30.0％),주치의사1 605/4 575명(35.1％),주원의사765/4 575명(16.7％). 결과 의사대BPH림상진전적주요표현화림상진전풍험예측인소적인식여지남적부합솔분별위43.4％ (2 023/4 665)화10.2％(477/4 660).대의사BPH환자적초시평고방법여지남적부합솔위20.2％(845/4 181),차존재현저적지구차이,불부합솔유고지저의차위동북지구66.5％ (290/436),중남/화남지구64.7％ (556/859),서북지구55.6％(158/284),화동지구55.1％(922/1 672),화북지구54.7％(435/795),서남지구48.0％ (296/617).의사대BPH적주요치료목적여지남적부합솔위4.9％(229/4 666),대관찰등대조건적인식여지남적부합솔위22.5％(1 051/4 674),대BPH환자수술치료괄응증적인식여지남적부합솔위94.6％(4410/4663).93.4％ (4388/4699)적의사인가5-α환원매억제제재축소전렬선체적방면적료효.의사대관찰등대환자、약물치료환자수방시적검사여지남부합솔부7.8％ (355/4 531)화8.4％(373/4 432),대술후환자수방시적검사여지남부합솔위44.8％(2 105/4 702). 결론 비뇨외과의사대CUA 2011판《량성전렬선증생진단치료지남》장악수평교저,유필요개전침대특정군체혹특정내용적배훈.
Objective The aim of this study was to investigate the understanding and application of the Chinese Urological Association (CUA) guidelines of Benign Prostatic Hyperplasia (BPH) (2011 edition) in Chinese urologists.Methods The survey was conducted between September,2012 and November,2012.Questionnaires designed by the CUA were used to investigate the understanding and management of BPH in CUA-registered urologists,who work in clinic for at least 20 hours per week.Data,including general characteristics of the urologists,understanding of BPH,BPH diagnosing in suspected patients,BPH treatment,and follow up,were collected.7500 questionnaires were distributed.A total of 4 897 participants responded (response rate 70.0％).86 questionnaires with incomplete information and 37 duplicate questionnaires were excluded.And 4 774 validate questionnaires were included for the analysis,finally.The mean age of those investigated urologists was (39.9±9.2) years old.Among them,3 802 (81.0％) urologists work in the tertiary hospital,878 (18.7％) urologists work in the secondary hospital and 12 (0.3％) urologists work in the other hospital.The district distribution in those urologists included 455 (9.6％) in northeast china,812 (17.1％) in north china,1 696 (35.6％) in east china,869 (18.2％) in south china,634 (13.3％) in southwest china,295 (6.2％) in northwest china.1 835 (43.8％) urologists have less than ten years working experience.1 505 (35.9％) urologists have 11 to 20 years working experience.The 21 to 20 years working experience was reported in 705 (16.8％) urologist.And the other 149 (3.5％) urologists have working experience more than 31 years.The educational background in this study included doctor degree in 732 (15.8％) urologists,master degree in 1 729 (37.4％) urologists,bachelor degree in 2 067 (44.7％)urologists and college degree in 101 (2.1％) urologists.The position composition included 834 (18.2) directors,1 371 (30.0％) deputy directors,1 605 (35.1％) attendings and 765 (16.7％) residents.The data were analyzed using rank-sum test,2 test,or Fisher's exact test.Results The understanding of BPH clinical progression and progression-associated risk factors in Chinese urologists was poor.Compared to the guidelines,the rate of consistent were only 43.4％ (2 023/4 665) and 10.2％ (477/4 660),respectively.The initial evaluation methods for suspected BPH patients were in low consistency with the guidelines (20.2％,845/4 181) and were inconsistent among different areas [66.5％ (290/436) in northeast china,64.7％ (556/859) in south china,55.6％ (158/284) in northwest china,55.1％ (922/1 672) in east china,54.7％ (435/795) in north china,48.0％ (296/617) in southwest china].The participants showed poor understanding of the primary goal of treatment for BPH (4.9％ consistent,229/4 666) and the criteria about watchful waiting (22.5％ consistent,1 051/4 674).However,the understanding of surgical indications for BPH was good (94.6％ consistent,4 410/4 663).The therapeutic effects of 5α-reductase inhibitor for BPH were acknowledged by 93.4％ (4 388/4 699) participants.The consistent rate with the guidelines of follow-up examinations was low for patients with watchful waiting (7.8％,355/4 531),medication treatment (8.4％,373/4432),and surgery (44.8％,2 105/4 702).Conclusions The understanding of the CUA BPH guidelines is poor in Chinese urologists.Target training in the specific urologists with tailored contents is necessary.
