摘要
目的调查基层医院的内科医师对抗HP治疗适应证、方案等问题的认知状况,分析其原因和提出解决办法。方法采用问卷方式,先调查四家二级医院内科医师对抗HP治疗适应证和治疗方案等问题的认知情况,再从各医院的计算机管理系统中,抽查2006年1月～2007年12月所有抗HP治疗的住院或门诊患者处方,并满足:①有胃镜检查资料、HP检测或病理检测资料;②开据处方的内科医师是本次调查对象;③不计治疗时间长短,均使用过质子泵抑制剂;④处方中使用有两种或以上抗生素。数据采用SPSS14.0统计软件进行统计学处理。结果本研究共调查内科医师217名,有157名对HP治疗的适应证(报警症状等方面)回答不全(72.2%),有172名临床医师对HP治疗的方案不能完全回答(79.4%),对如何避免或克服HP耐药性问题不能准确回答有188名(86.5%),比值比分别为2.59、3.85、6.41,有81.6%的内科医师未经过消化内科正规轮转(177/217)。符合调查要求的患者处方共2374例,应属于治疗范畴有894例,占总例数37.6%,2157例进行了不规范治疗(90.8%),二者有统计学意义(P<0.01)。1143例选择三联治疗方案(48.2%),1231例选择四联治疗方案(51.8%),2245例配伍了多种药物(94.5%),这三者之间无统计学意义(P>0.05)。结论结果显示我国基层医院的内科医师对抗HP的治疗适应证和方案等问题的认知状况十分混乱,治疗中随意配伍其它药物和对如何避免或克服HP耐药性等问题不能准确问答。
Objective To investigate the physicians on anti-HP treatment indication,program and other issues of the congrfitive situation,analyse its causes and propose solutions. Methods First to send out questionnaires to investigate four two-level-hospital physicians about anfi-HP treatment indications, treatment programs and other cognitive problems. Then carry out selective examinations of all anti-HP＇s in-patient treatmnet and outpatient prescriptions from January 2006 to December 2007 by using the hospital＇s computer system, the samples should meet these demands：（1） have the gastroseopy information, HP testing or pathological examination information; （2） physicians who write out the prescription is the object of this investigation; （3）Not care for the time of treatment,patients are used PPI; （4）There are two types of antibiotics or over in prescriptions, Data is disposed by SPSS14.0 statistical software. Results This study investigated a total of 217 physicians, including 157 patients of HP treatment indication（ alarm symptoms,and so on ）answered ineompletly （72.2%）, 172 clinicians can not answer completely about the HP treatment programe（79.4 percent）, 188 can not have a precise answer to how to avoid or overcome HP drug resistance problem （ 86.5 % ）, the ratio respectively is 2.59, 3.85,6.41,81.6 percent of the physicians does not rotate regularly trough the digest internal medicine（177/217）.In hne with the requirements of the investigation are total of 2374 prescription cases, which shoule belong to treatment are 894 eases, accounting for 37.6 percent of the total number of eases, 2157 cases were carried out by non-standard treatment （90.8%） ,there are two significant differences（ P 〈 0.01 ） . 1143 eases of triple combine choice of treatment （48.2 % ）, 1231 cases of quadruple combine treatment option 51.8 % ）, 2245 eases of a combination of many drugs（94.5 %）, among which there was no significant difference（ P 〉 0.05）. Conclusion To the analysis, indiates that physicians in China＇s grass-roots hospitals are in disodercd congnitive situation of anfi-HP treatment indication, programe and other issues,they combine drugs radomly during the treatment and can not give the precise answer on how to avoid or overcome the resistance of HP and other issues.
出处
《四川医学》
CAS
2009年第3期416-418,共3页
Sichuan Medical Journal
关键词
幽门螺杆菌
治疗
认知状况
调查和分析
helicobacter pylori
treatment
comgnitive situation
investigation and analysis
