摘要
目的了解上海市浦东新区全科医生对心房颤动(房颤)的认识情况,探讨认识中的不足及改进方法。方法2016年7—9月,采用分层整群抽样法,抽取上海市浦东新区12家社区卫生服务中心符合纳入标准的全科医生进行问卷调查。问卷为课题组依据《心房颤动:目前的认识和治疗建议-2015》指南自拟,内容主要分为5部分:临床评估、抗栓治疗、节律控制、心率控制及对指南的使用和评价。结果共发放问卷387份,回收有效问卷371份(95.8%)。男151名,女220名,年龄(41_3±8-3)岁,初级职称156名(42.0%)、中级职称158名(42.6%)、高级职称57名(15.4%)。全科医生中认识到老年、高血压、心肌梗死、心脏瓣膜病是房颤危险因素的比例高于90%。对房颤患者做临床评估时,54.2%(201/371)的全科医生选择动态心电图,47.9%(178/371)选择甲状腺功能,21.0%(78/371)选择超声心动图,3.2%(12/371)选择呼吸睡眠监测。95.4%(354/371)的全科医生没有听说过心血管植入型电子器械。房颤抗凝适应证方面,选择风湿性二尖瓣狭窄、血栓栓塞危险积分≥2分或肥厚型心肌病的比例分别为82.2%(305/371)、46.4%(172/371)和12.7%(47/371)。38.5%(143/371)的全科医生很少使用血栓栓塞危险积分。选择对初发房颤、心室率控制后症状仍不缓解、有相关症状的房颤患者进行节律控制的比例分别为42.9%(159/371)、39.9%(148/3711、12.7%(47/371)。59.8%(222/371)的全科医生不知晓房颤复律的抗凝治疗。44.5%(165/371)没有听说过房颤射频消融术。38.5%(143/371)知晓房颤指南,其中45.5%(65/143)有时会使用该指南,80.4%(115/143)认为该指南指导性很大。不同职称间比较,高级职称全科医生对临床评估、抗栓治疗、对导管消融术的了解和指南知晓率好于初、中职称全科医生。结论在对房颤相关知识的认识中,浦东新区全科医生对其危险因素、临床评估方法、抗凝适应证及复律抗凝治疗�
Objective To survey the knowledge level of atrial fibrillation (AF)among general practitioners (GPs)in Shanghai Pudong New Area.Methods From July to September 2016,a stratified cluster sampling method was used to collect questionnaires from GPs who met the inclusion criteria in 12 community health service centers in Shanghai Pudong New Area.A self-made questionnaire was applied according to Current knowledge and management recommendations of atrial fibrillation-2015,which included 5domains:antithrombotic therapy,rhythm control,ventricular rate control and evaluation of the guideline. Results A total of 377questionnaires were distributed,and 371were recovered.Among 371participants there were 151males and 220females aged (41.3±8.3)years,including 156(42.0%)with junior professional titles,158(42.6%)with intermediate titles,and 57(15.4%)with senior titles.More than 90%of participants recognized that age,hypertension,myocardial infarction,and heart valve disease were risk factors of AF.For patient evaluation,54.2%(201/371)of participants would use electrocardiogram,47.9%(178/371)would use thyroid function,21.0%(78/371)would use echocardiography,3.2%(12/371)would use respiratory sleep monitoring,and 95.4%(354/371)did not heard of cardiovascular implantable electronic devices.82.2%(305/ 371)of participants thought rheumatic mitral stenosis,46.4%(172/371)thought CHA2DS2-VASc score over and 2and 12.7%(47/371)thought hypertrophic cardiomyopathy as indications for anticoagulant;and 38.5% (143/371)of participants rarely used CHA2DS2-VASc.The rhythm conversion would applied for the onset of atrial fibrillation in 42.9%participants (159/371),for symptoms after the control of ventricular rate in 39.9% (148/371)participants and for symptomatic patients in 12.7%participants (47/371).59.8%(222/371)of participants did not know the anticoagulation therapy for AF cardioversion,44.5%(165/371)participants had not heard radiofrequency ablation for AF.38.5%(143/371)of participants knew the Chinese guidelines for AF,of which 45.5%(65/143
作者
倪岚
薛锦花
薛峰
Ni Lan;Xue Jinhua;Xue Feng(Department of General Practice,Hudong Community Health Service Center of Pudong New Area,Shanghai 200129,China)
出处
《中华全科医师杂志》
2018年第11期895-900,共6页
Chinese Journal of General Practitioners
基金
上海市浦东新区卫生和计划生育委员会科技发展专项基金资助(PW2015C-7)。
关键词
心房颤动
社区卫生中心
全科医生
问卷调查
Atrial fibrillation
Community health centers
General practitioner
Questionnaire survey
