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上海浦东新区全科医师对规范化诊治幽门螺杆菌感染掌握程度的调研

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  • 1.上海市浦东新区惠南社区卫生服务中心全科,上海 201300
    2.上海市浦东新区大团社区卫生服务中心全科,上海 201311
    3.上海交通大学医学院附属瑞金医院老年科,上海 200025

收稿日期: 2021-12-28

  网络出版日期: 2022-08-17

基金资助

上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2020-17)

Investigation on mastery status of standardized diagnosis and treatment of Helicobacter pylori(Hp) infection in general practitioners in Pudong New Aera, Shanghai

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  • 1. Department of General Practice, Huinan Community Health Severice Center of Pudong New District, Shanghai 201300, China
    2. Department of General Practice, Datuan Community Health Severice Center of Pudong New District, Shanghai 201311, China
    3. Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-12-28

  Online published: 2022-08-17

摘要

目的:调查上海市浦东新区全科医师对幽门螺旋杆菌(Helicobacter pylori,Hp)感染规范化诊治掌握程度及其影响因素。方法:2021年1月至5月,采用分层随机抽样法抽取浦东新区24家社区卫生服务中心的348名全科医师,自制调研问卷(满分30分),采用问卷星调查被调研者基本情况和他们对Hp感染诊断、治疗及预防相关知识的掌握程度,并根据得分情况将全科医师分为掌握不良组(0~10分)、掌握一般组(11~20分)和掌握良好组(21~30分),比较组间差异。结果:本次调查共收集有效问卷320份,本地区全科医师对Hp感染规范诊治的掌握水平较高,平均得分为21.69分(总分30分)。本研究中,掌握一般组有116人,占36.25%,平均得分为17.53分;掌握良好组有204人,占63.75%,平均得分为24.05分,掌握不良组0人。Hp现症感染的诊断方面,仅50.0%的全科医师知晓粪便Hp抗原阳性也是诊断Hp感染的标准之一,而有66.6%的全科医师误认为血清Hp抗体阳性也可诊断Hp感染。Hp感染根除治疗指征方面,仅41.9%的全科医师认为“证实有Hp感染”是根除治疗的适应证。掌握一般组与掌握良好组的医师在学历和工作年限方面存在统计学差异;而在Hp感染的规范治疗、随访和预防方面,2组间除抗菌药物选择无统计学差异外,其余选项均有统计学差异(P<0.05)。Logistics回归分析提示,工作年限是影响全科医师对Hp感染规范化诊治掌握程度的因素,与掌握程度呈反比。结论:浦东新区全科医师对Hp现症感染和根除治疗适应证相关知识的掌握程度有待提高,工作年限长的全科医师对规范化诊治Hp掌握程度较低,故本区需在全体全科医师,尤其是高年资全科医师中,加强Hp感染诊断、根除治疗适应证相关知识的培训。

本文引用格式

阮玉凤, 胡丽萍, 陈史蓉, 尹君, 孙璟 . 上海浦东新区全科医师对规范化诊治幽门螺杆菌感染掌握程度的调研[J]. 诊断学理论与实践, 2022 , 21(03) : 399 -404 . DOI: 10.16150/j.1671-2870.2022.03.019

Abstract

Objective: To investigate the mastery status of standard diagnosis and treatment of Helicobacter pylori (Hp) infection among general practitioners in Pudong New Area of Shanghai and its influencing factors. Methods: From January to May in 2021, 348 general practitioners from 24 community health service centers in Pudong New Area were selected by using stratified random sampling method. A self-made questionnaire (full score of 30) was used to investigate the general practitioners′ mastery of Hp infection diagnosis, treatment and prevention. According to the scores, they were divided into poor mastery group (0-10 points), moderate mastery group (11-20 points) and good mastery group (21-30 points), and the differences among the groups were compared. Results: A total of 320 valid questionnaires were collected in this survey, and the general practitioners′ mastery of standard diagnosis and treatment of Hp infection was at a high level, with an average score of 21.69. There were 116 people in the moderate mastery group, accounting for 36.25%, with an average score of 17.53 points. There were 204 people in the good mastery group, accounting for 63.75%, with an average score of 24.05 points, and 0 people in the poor mastery group. For diagnosis of current Hp infection, only 50.0% of general practitioners knew that fecal Hp antigen positive was one of diagnostic criteria, while 66.6% of general practi-tioners mistakenly believed that serum Hp antibody positive could be used for diagnosing Hp infection. In terms of indications for eradication treatment of Hp infection, only 41.9% of general practitioners believed that "confirmation of Hp infection" was the indication of eradication treatment. There were significant differences in educational background and working years between the moderate mastery group and the good mastery group. In terms of standardized treatment, fol-lowup and prevention of Hp infection, there were significant differences in other options between the two groups except for the choice of antibiotics (P<0.05). Logistic regression analysis showed that the working years was the influencing factors for the general practitioners′ mastery of the standardized diagnosis and treatment of Hp infection, which was inversely proportional to the mastery. Conclusions: The general practitioners in Pudong New Area do not have enough knowledge about the current infection of Hp and the indications of eradication treatment. It is necessary to strengthen the training on the indications of diagnosis and eradication treatment of Hp infection among all general practitioners, especially senior general practitioners.

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