目的 了解南京市基层医院内科医生对慢性阻塞性肺疾病(COPD)的认识水平及COPD的治疗现状,为今后开展针对性的继续教育提供依据. 方法 2009年6月至12月,采用分层随机抽样的方法对南京市二级医院及社区卫生服务中心内科医生进行面对面访谈,主要调查内容包括对COPD认知水平、轻中度及重度COPD患者处方用药情况、监测肺功能情况、对稳定期COPD患者是否需要治疗的认知状况、对于治疗COPD常用药物的认识和评价,以及内科医生自身吸烟情况. 结果 此次共调查了南京市6家二级医院及社区卫生服务中心共计69名内科医生,对COPD的危害认识比较全面,诊断COPD时会询问患者慢性咳嗽和气流受阻情况；只有85.5％内科医生认知到肺功能检查对诊断COPD有重要意义,对于肺功能各项指标诊断COPD的临床意义不清楚,仍有15.9％的内科医生不重视稳定期的治疗.对于轻、中、重度COPD患者的治疗不够规范,对于祛痰药评价过高,应用频率也较高.内科医生吸烟比例为17.4％. 结论 目前南京市基层医院内科医生对于COPD的认知水平较高,但对COPD的治疗欠规范,长期防控干预还有一定差距,需要进行肺功能方面的专业继续教育,医生在控烟工作中应起表率作用.%Objective To investigate physicians' cognitive level and the status of treatment about COPD in basic hospitals in Nanjing, and to provide scientific evidence for targeted education in the future. Methods Stratified random sampling method and face to face interview were used. The research contents mainly included physicians' cognitive level, prescription for mild, moderate and severe COPD patients, the monitoring situation of lung function, cognitive status of the treatment for stable COPD patients, cognition and assessment to commonly used drugs for COPD, and the status of physicians' smoking. Results Sixty-nine physicians from 6 basic hospitals were investigated. All physicians knew the GOLD guideline for COPD about prevention and treatment, understanding the harm of COPD comprehensively and paid attention to the treatment of COPD in stable period. But the recognitive rate of lung function test was low, the status of recognizing the significance of lung function indicators was not well, and they overestimated expectorants which were used in high frequency. The study also found that 84. 1% of the physicians of basic hospitals realized that it was important to treat COPD in stable period, and 17. 4% of them smoked. Conclusions At present, the level of the cognition of COPD in physicians in basic hospitals of Nanjing is high, but they need to take more effort on medication and long-term prevention and control of COPD.
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