甘肃省不同级别医院哮喘患者的控制现状及对疾病认知程度的基线调查  

Asthma Control and Knowledge Level about Disease in Asthmatic Patients: A Baseline Investigation in Hospitals of Different Grades in Gansu Province

作　　者：包海荣[1] 杨洁 郭超 刘晓菊[1] 张艺[1] 谭恩丽[1] 曾晓丽[1] 

机构地区：[1]兰州大学第一医院老年呼吸科甘肃兰州730000 [2]玉门市第一人民医院甘肃玉门735200 [3]兰州石化总医院呼吸科甘肃兰州730060

出　　处：《中国呼吸与危重监护杂志》2013年第5期446-450,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：中华医学会临床医学慢性呼吸道疾病科研专项资金(编号:07010240032)

摘　　要：目的了解甘肃省不同级别医院哮喘患者的控制现状和对疾病的认知程度,为本地区的哮喘防治工作提供参考。方法选择甘肃省三甲医院、三乙医院和二甲医院,以面对面问卷形式对医院门诊或住院的哮喘患者进行调查。结果完成调查的患者共542例。①哮喘控制情况:按照哮喘控制测试(ACT),完全控制、良好控制和未控制者分别为3.5%、16.9%和79.5%。三个不同级别医院哮喘患者完全控制率均较低,无明显差异;三甲医院和三乙医院良好控制比例明显高于二甲医院(P<0.05)。41.1%的患者在过去1年因疾病加重而住院。二甲医院住院者明显多于三甲医院和三乙医院(P均<0.01),三乙医院多于三甲医院(P<0.05)。46.9%的患者看过急诊,二甲医院看急诊者明显多于三甲医院和三乙医院(P均<0.01)。②哮喘管理情况:在过去1年中进行肺功能随访者23.6%,三甲医院随访者明显多于三乙医院和二甲医院(P均<0.01)。只有2.8%的三甲医院患者每日规律使用峰流速仪。专科医生为患者制定长期治疗计划者19.7%,其中三甲医院和三乙医院高于二甲医院(P均<0.05)。③药物治疗情况:30.6%的患者规律使用吸入皮质激素(ICS)或ICS联合长效β2受体激动剂(ICS/LABA)治疗,其中三甲医院与三乙医院差异无统计学意义,但均高于二甲医院(P均<0.05)。27.7%的患者规律使用茶碱治疗,三级医院之间无明显差异;30.3%的患者未规律使用药物,主要为二甲医院和三乙医院患者(分别为54.1%和32.9%)。11.4%的患者使用抗生素、中药等非常规药物治疗,主要为二甲医院和三乙医院患者(分别为50%和30.6%)。④疾病的认知程度:26.2%的患者理解哮喘是炎症性疾病;51.3%的患者认为ICS或ICS/LABA应作为哮喘长期治疗药物,三甲医院的回答情况优于三乙医院和二甲医院(P均<0.05);1年内参加过哮喘讲座的患者为13.1%~14.7%,三甲医院略优于三乙医院和二甲医院,但差�Objective To evaluate the control status and knowledge level about disease in asthmatic patients in hospitals of different grades in Gansu province, and provide a basis for proposing a work plan for prevention and treatment of asthma in Gansu province. Methods We performed a questionnaire investigation in a face-to-face manner in asthmatic patients from hospitals of three different grades, which included a grade 3A hospital, a grade 3B hospital, and a grade 2A hospital. Results A total of 542 asthmatic patients were investigated. The percentage of complete controlled, well controlled and uncontrolled were 3.5% , 16.9% and 79.5% respectively. The rate of complete controlled was low in three hospitals without significant difference （3.6% , 3.4% , and 3.3% , respectively）. The rate of well controlled in the grade 3A and 3B hospitals was higher than that in the grade 2A hospital （20.4% and 18.3% vs. 8.2% , P 〈0. 05）. 41.4% of the respondents had been hospitalized for exacerbation in the past one year,and the rate was higher in the grade 2A hospital than that in the grade 3A and 3B hospitals （58.2% vs. 31.8% and 42. 9% ,P 〈0. 01）. 46. 9% of the patients had visited the emergency department,and the rate was higher in the grade 2A hospital than that in the grade 3A and 3B hospitals （63.9% vs. 41.6% and 42. 3% ,P 〈0.01）. 23.6% of the respondents had underwent lung function test follow-up during the past one year,and the rate in the grade 3A hospital was higher than that in the grade 3B and 2A hospitals（79.2% vs. 44% and 40. 2% ,P 〈0. 01 ）. Only 2. 8% of the patients in the grade 3A hospital had used peak flow meter regularly. There were 19. 7% of the patients received a long-term treatment plan by specialists, and the rate in the grade 3A and 3B hospitals was higher than that in the grade 2A hospital （22. 4% and 21.7% vs. 11.5%, P 〈0. 05）. 30. 6% of the respondents insisted on using inhaled corticosteroid （ICS） or combination of ICS and long acting 13^-agonist （ICS/LABA） ,and the

关 键 词：哮喘 控制 问卷调查 疾病认知 

分 类 号：R562.25[医药卫生—呼吸系统]