CAJ | 학술논문

背景随着社会老龄化，良性前列腺增生症（BPH）人群日益增多。社区医院 BPH 诊治有待规范。目的了解上海市社区医师对 BPH 的认知现状，并比较不同培训策略的效果，为 BPH 社区规范治疗提供依据。方法2011年2月—2013年2月抽取上海市中心城区6家社区卫生服务中心的日常工作中经常接触 BPH 患者的全科医师、外科医师或其他各科医师119人，采用随机数字表法将6家社区卫生服务中心分为3组：第一组不进行任何形式的 BPH相关知识培训，第二组每半年进行1次 BPH 相关知识培训，第三组每季度进行1次 BPH 相关知识培训。调查社区医师对 BPH、BPH 诊断、国际前列腺症状评分（IPSS）及中国 BPH 指南的认知情况。结果3组社区医师对 BPH 的疾病名称、症状、不是前列腺癌癌前病变的认知率比较，差异均无统计学意义（P >0.05）。第二组和第三组社区医师对前列腺体积分度、前列腺特异抗原（PSA）检测目的、尿流率检测目的、IPSS、IPSS 具体项目、IPSS 总分、治疗方案临界值、指南推荐的治疗方法、手术适应证的认知率高于第一组（P <0.05）。结论目前社区医师对 BPH 的诊治有初步认识，但对该病的规范化诊断治疗掌握不够，每半年进行1次 BPH 相关知识的培训可以显著提高社区医师对于一些关键指标的把握，规范 BPH 的诊治活动。
배경수착사회노령화，량성전렬선증생증（BPH）인군일익증다。사구의원 BPH 진치유대규범。목적료해상해시사구의사대 BPH 적인지현상，병비교불동배훈책략적효과，위 BPH 사구규범치료제공의거。방법2011년2월—2013년2월추취상해시중심성구6가사구위생복무중심적일상공작중경상접촉 BPH 환자적전과의사、외과의사혹기타각과의사119인，채용수궤수자표법장6가사구위생복무중심분위3조：제일조불진행임하형식적 BPH상관지식배훈，제이조매반년진행1차 BPH 상관지식배훈，제삼조매계도진행1차 BPH 상관지식배훈。조사사구의사대 BPH、BPH 진단、국제전렬선증상평분（IPSS）급중국 BPH 지남적인지정황。결과3조사구의사대 BPH 적질병명칭、증상、불시전렬선암암전병변적인지솔비교，차이균무통계학의의（P >0.05）。제이조화제삼조사구의사대전렬선체적분도、전렬선특이항원（PSA）검측목적、뇨류솔검측목적、IPSS、IPSS 구체항목、IPSS 총분、치료방안림계치、지남추천적치료방법、수술괄응증적인지솔고우제일조（P <0.05）。결론목전사구의사대 BPH 적진치유초보인식，단대해병적규범화진단치료장악불구，매반년진행1차 BPH 상관지식적배훈가이현저제고사구의사대우일사관건지표적파악，규범 BPH 적진치활동。
Background With the aging process of our society,more and more elderly men are affected by benign prostate hyperplasia ( BPH ) . The diagnosis and treatment protocols of BPH in community hospitals need more guidance. Objectjve To investigate the cognitive status quo of BPH in community doctors in Shanghai,compare the efficacy of different training programs and provide evidences for standardized treatment of BPH in community. Methods From February 2011 to February 2013,119 doctors(including general practitioners,surgeons,and other practitioners)in six community hospitals in Shanghai who usually encountered BPH patients,were selected as study subjects. Then the six hospitals were randomly divided into three groups:doctors in Group 1 did not receive any training about BPH - related knowledge. Doctors in Group 2 received training about BPH - related knowledge every 6 months. Doctors in Group 3 received training about BPH - related knowledge every 3 months. The recognition degree of BPH,the knowledge about BPH diagnosis,international prostate symptom score(IPSS)and Chinese guidelines of BPH among the community doctors were studied. Results There was no significant difference in knowledge about BPH name,BPH symptom,and 〞 BPH is not a kind of precancerous lesion of prostate cancer〞 among three groups of community doctors(P > 0. 05). Doctors in Group 2 and Group 3 knew better than Group 1 about degrees of prostate volume, significance of PSA and urine flow rate,IPSS,each item in IPSS,total score of IPSS,critical value of BPH treatment protocols, guideline - recommended treatment and operative indications(P < 0. 05). Conclusjon Doctors in community hospitals know preliminary knowledge about BPH,but they are not familiar with details in diagnosis and treatment. A BPH related training every 6 months can significantly increase their knowledge about some important indicators,which could standardize BPH treatment in community hospitals.