摘要
目的:了解国内呼吸专科医师对支气管扩张症的诊疗认知现状。方法:于2020年5—6月,基于支气管扩张症专家共识及诊疗指南设计问卷,对四川省、云南省50家医院的呼吸专科医师进行问卷调查,共发放问卷691份,收回641份,筛选后获得有效问卷601份(有效回收率87.0%)。调查采用电子问卷方式,由受访医师根据对该病的认知独立作答,调查内容主要包括对支气管扩张症诊断、严重程度评估、治疗以及中医中药临床应用等方面。对反馈结果进行统计学分析并依据相应问题的回答正确率来评估受访医师的认知现况。结果:540名(89.9%)受访医师认可胸部高分辨率CT扫描是支气管扩张症确诊的“金标准”,但318名(52.9%)对常见影像学表现认知不全面,不同级别医院或不同学历的医师对支气管扩张症影像学的认识也有一定差异(P<0.05)。仅118名(19.6%)受访医师比较了解支气管扩张症严重程度评估。但在比较了解该两种评分的118名受访医生中,65名(55.1%)表示不会在临床工作中主动将该评分用于患者评估。对稳定期患者,受访医师最为推荐的治疗方式是气道清除技术[410名(68.2%)],最主要的治疗手段是体位引流[559名(93.0%)]。对急性加重期患者,绝大多数受访医师推荐首要治疗方式为抗生素治疗[600名(99.8%)],同时需完善痰培养[544名(90.5%)]、血炎性标志物[523名(87.0%)]等检查。504名(83.9%)受访医师认为铜绿假单胞菌是支气管扩张症最见病原菌。对反复加重患者,385名(64.1%)受访医师认为长期抗生素是一种可行的治疗方案。在认可该治疗方法的385名受访医生中,仅113(29.4%)名表示愿意在临床工作中为反复加重患者推荐长期抗生素治疗。其他治疗手段中,304名(50.6%)受访医师对中医药治疗支气管扩张症的疗效持有支持态度。然而,在持支持态度的304名受访医生中,仅86名(28.3%)会主动向患者推荐中医中�
Objective To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods Between May and June 2020,a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces.Total 691 questionnaires were distributed and 641 were received.601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%.The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing,severity assessment,treatments and Chinese medicines of bronchiectasis.The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results 540(89.9%)of the respondents agreed that high-resolution computed tomography(HRCT)was the gold standard for diagnosing of bronchiectasis,but 318(52.9%)had an incomplete understanding of common radiographic manifestations of bronchiectasis,and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals(P<0.05).Only 118(19.6%)of the respondents were familiar with severity assessments of bronchiectasis,but 65(55.1%)of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works.For the treatment of patients with stable bronchiectasis,airway clearance techniques were most recommended by specialists surveyed[410(68.2%)],among which,postural drainage was the most known method[559(93.0%)].For patients undergoing an acute exacerbation,most respondents recommended antibiotics[600(99.8%)]as the primary treatment,and examinations such as sputum culture[544(90.5%)],inflammatory markers[523(87.0%)]should be performed as well.504(83.9%)thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis.For patients with frequent exacerbations(
作者
雷玲子
王浩
王冉
胡强
李志伟
董琼
刘真
李文
文富强
Lei Lingzi;Wang Hao;Wang Ran;Hu Qiang;Li Zhiwei;Dong Qiong;Liu Zhen;Li Wen;Wen Fuqiang(Department of Respiratory and Critical Care Medicine,West China Hospital of Sichuan University and Division of Pulmonary Diseases,State Key Laboratory of Biotherapy of China,Chengdu 610041,China;Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Panzhihua University,Panzhihua 617000,China;Department of Respiratory and Critical Care Medicine,Western Theater General Hospital,Chengdu 610083,China;Department of Respiratory and Critical Care Medicine,Nanchong Central Hospital,Nanchong 637000,China;Department of Respiratory and Critical Care Medicine,First Hospital of Liangshan Yi Autonomous Prefecture,Liangshan 615000,China;Department of Respiratory and Critical Care Medicine,Pengzhou People′s Hospital,Pengzhou 611930,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2021年第3期252-257,共6页
Chinese Journal of Health Management
基金
四川大学华西医院1.3.5高端人才项目(ZYGD18006)。
关键词
支气管扩张症
问卷调查
呼吸专科医师
诊疗认知
Bronchiectasis
Questionnaires
Respiratory specialists
Cognition on diagnosis and treatment of bronchiectasis
