反流性食管炎和非糜烂性反流病患者的疾病认知和既往诊治情况调查  

Investigation on Disease Recognition and Previous Status of Examination and Treatment in Patients with Reflux Esophagitis and Non-erosive Reflux Disease

作　　者：吴欢[1] 陈芷珉[1] 孙晓红[1] 王智凤[1] 柯美云[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院消化内科

出　　处：《胃肠病学》2010年第4期200-204,共5页Chinese Journal of Gastroenterology

摘　　要：背景：胃食管反流病（GERD）是临床常见疾病,患者常反复就医,医疗资源耗费大.目的：了解GERD患者对疾病的认知和既往诊治情况,探讨其影响因素.方法：对GERD患者行问卷调查,分析反流性食管炎（RE）和非糜烂性反流病（NERD）患者的人口学特征、就诊原因、疾病认知和既往诊治情况.结果：共244例GERD患者接受调查,NERD152例,RE 92例.就诊原因为反流相关症状、明确诊断和担心患肿瘤者分别占75.4%、31.5%和26.1%.34.8%的患者对罹患该病非常担心紧张,23.0%的患者诊疗费用≥20 000元,仅23.4%的患者对既往治疗效果表示满意.Logistic回归分析显示,性别、年龄是疾病认知的主要影响因素,病程长、RE是诊疗费用高的主要危险因素,年龄是满意度的主要影响因素.RE和NERD组对该病不甚了解者均达85%以上.RE组男性、轻体力劳动者比例和腹围、体重指数显著高于NERD组,因担心患肿瘤而就诊、曾接受非药物治疗、诊疗费用≥20 000元者比例亦高于NERD组,且较NERD组更担心发展为食管癌和药物不良反应.结论：GERD患者对该病的认知有限,诊疗费用高.有针对性地对不同类型的GERD患者进行疾病认知教育,加强非药物治疗的宣教.有望节约医疗资源.更好地治疗疾病.Background： Gastroesophageal reflux disease （GERD） is a commonly seen disorder in clinical practice. Patients usually visit hospitals repeatedly and waste medical resources. Aims： To investigate the disease recognition and previous status of examination and treatment in GERD patients, as well as their influencing factors. Methods： GERD patients were recruited consecutively to answer the questionnaire. The demography, causes of visiting hospital, disease recognition, and previous status of examination and treatment were analyzed in reflux esophagitis （RE） and non-erosive reflux disease （NERD） patients. Results： Two hundred and forty-four GERD patients were investigated, including 152 NERD and 92 RE. The proportion of patients visiting hospital for reflux-related symptoms was 75.4%, and that for further diagnosis and fear of cancer were 31.5% and 26.1%, respectively; 34.8% of the patients worried about GERD anxiously, 23.0% complained the expenditure for GERD 〉~CNY 20 000, and only 23.4% were satisfied with previous therapy. Logistic regression analysis demonstrated that gender and age were the primary influencing factors for disease recognition; long disease course and RE were the primary risk factors for high expenditure, while age was the primary influencing factor for satisfaction. In both NERD group and RE group, majority of patients （〉85%） did not understand well what GERD was. The proportions of male and mild physical laborer, as well as abdominal circumference and body mass index were significantly higher in RE group than in NERD group. The proportions of patients who visited hospitals for fear of cancer, ever tried non-drug therapies and paid expenditure 〉~CNY 20 000 for GERD, were also significantly higher in RE group than in NERD group. More RE patients worried about developing esophageal cancer and drug-related adverse effects. Conclusions： GERD patients have limited disease recognition and high expenditure related to the disease. Various disease recognition educations ai

关 键 词：胃食管反流 疾病认知 问卷调查 

分 类 号：R571[医药卫生—消化系统]