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目的了解基层医生对慢性阻塞性肺疾病(COPD)相关知识的认识情况。方法2007年12月采用不记名闭卷笔试的方法对北京市10个城区与郊区共400名基层医生进行COPD知识问卷调查。内容涉及COPD的定义和危险因素、常见临床症状、非药物治疗(康复锻炼、戒烟、疫苗接种)、药物治疗(吸入支气管舒张剂、抗菌素治疗、口服糖皮质激素、吸入糖皮质激素)。结果本次调查共回收有效问卷372份,平均(50.1±20.6)分,及格率42.5%。30岁～、40岁～组医师及格率和成绩分别为57.6%、(55.2±20.6)分和51.9%、(55.6±14.2)分,优于20岁～组和≥50岁组,差别有统计学意义(P<0.05)。本科学历组及格率为68.7%,平均成绩为(58.5±17.0)分,优于中专和大专组,差别有统计学意义(P<0.05)。中级职称组及格率为49.0%,成绩(53.8±19.8)分,优于初级职称组,差别有统计学意义(P<0.05)。社区服务站医师77人,平均(57.5±15.1)分,及格率57.1%;一级医院医师107人,平均(49.5±16.4)分,及格率32.7%;二级医院医师188人,平均(47.5±23.8)分,及格率42.0%;社区服务站医师平均分和及格率均优于一级和二级医院,差别有统计学意义(P<0.05)。结论基层医院医生对于COPD临床知识与技能欠缺,迫切需要加强基层医生COPD知识教育。
Objective To understand the knowledge of primary care doctors about chronic obstructive pulmonary disease (COPD). Methods In December 2007, a total of 400 grassroots doctors in 10 urban and suburban areas of Beijing were surveyed by means of anonymous written examination. It covers definitions and risk factors for COPD, common clinical symptoms, non-medical treatment (rehabilitation exercise, smoking cessation, vaccination), medications (inhaled bronchodilator, antibiotic treatment, oral glucocorticoids, inhaled corticosteroids). Results In this survey, 372 valid questionnaires were collected, with an average of (50.1 ± 20.6) points and a pass rate of 42.5%. The passing rate and the scores of the group of physicians from the age of 30 to 40 years old were 57.6%, 55.2 ± 20.6 and 51.9%, respectively, which were significantly higher than those of the patients aged 20 to 50 years Significance (P <0.05). The passing rate of undergraduate education group is 68.7%, with an average score of (58.5 ± 17.0) points, which is better than that of secondary technical school and college education. The difference is statistically significant (P <0.05). The middle grade grade group had a pass rate of 49.0% and a score of (53.8 ± 19.8) points, which was better than the junior grade group, with a significant difference (P <0.05). There were 77 community service physicians, with an average of (57.5 ± 15.1) points and a pass rate of 57.1%. There were 107 primary hospital doctors with an average of 49.5 ± 16.4 points and a passing rate of 32.7%. There were 188 secondary hospital doctors with an average of 47.5 ± 23.8) points, the passing rate was 42.0%. The average score and passing rate of physicians in community service stations were superior to those in first and second level hospitals, with statistical significance (P <0.05). Conclusion The primary hospital doctors lack of clinical knowledge and skills for COPD, there is an urgent need to strengthen grassroots doctors COPD knowledge education.