广州市老城区风湿科门诊病种构成及诊治状况分析  

THE STRUCTURE AND CONDITION ANALYSIS OF RHEUMATOLOGY OUTPATIENT ENTITIES IN GUANGZHOU OLD TOWN AREA

作　　者：吴炜戎[1] 张建瑜[2] 蒋春梅[1] 谢启新 蔡晓燕[1] 

机构地区：[1]广州医学院荔湾医院,广东广州510170 [2]广州医科大学附属第三医院,广东广州510150

出　　处：《现代医院》2015年第8期103-105,共3页Modern Hospitals

基　　金：广东省中医药局建设中医药强省2012年度科研课题(编号:20122103);广州市荔湾区2013年度科技计划项目(编号:20131215072)

摘　　要：目的：调查广州市老城区风湿科门诊病种构成、分析患者就诊影响因素及诊治状况。方法对2013年1月1日∽6月30日就诊于广州医学院荔湾医院及广州医科大学附属第三医院风湿科的5220名风湿病人进行横断面调查，医生填写调查表并记录检验结果等，最后进行统计学分析。结果就诊患者以本地老年居民为主，骨关节炎（ OA）、痛风、类风湿关节炎（ RA）、骨质疏松症（ OP）、反应性关节炎、强直性脊柱炎（ AS）、系统性红斑狼疮（ SLE）是广州老城区风湿科门诊最常见的7个病种。 RA、反应性关节炎、SLE等疗效较好的病种或学历较高的患者依从性最高；老年患者及低收入、低学历患者对风湿病知识掌握严重不足，对风湿病危害性重视不够；低学历、低收入的风湿病人不规范治疗率最高。医疗费用最高的是使用生物制剂（依那西普）的AS，其次为RA、骨质疏松症和SLE。结论广州老城区风湿科门诊病种有自身特点，不规范治疗所占比例很高，与居民对风湿病普遍重视不够、患者健康教育滞后、部分药品价格过高、低收入患者难以承受医疗费用及医患沟通不够等因素有关。应根据上述特点采取积极的应对措施。Objective To survey the structure of rheumatism outpatient entities, diagnostic and therapeutic conditions and to analyze the influential factors in rheumatology outpatients in Guangzhou old town area .Methods Investigating all rheumatology out-patients in Liwan Hospital of Guangzhou Medical University and The Third Affiliated Hospital of Guangzhou Medical University from Jan 1st to June 30th ,2013.Cross-sectional studies were done in 5220 outpatients.Doctors filled the Questionnaires and recorded the test results and so on, then made statistical analysis.Results The patients are mainly local elderly citizens, and the seven most common entities of Rheumatology outpatients entities in Guangzhou old town area are osteoarthritis （ OA） , gout, rheumatoid arthritis （RA）, osteoporosis（OP）, adjuvant arthritis, ankylosing spondylitis （AS） and systemic lupus erythematosus （SLE）.The entities of better curative effects of RA , adjuvant arthritis and SLE have more compliance as well as the patients of higher education .The elderly and patients with low income or low education seriously lack the knowledge for rheumatism , not paying much attention to the harmful-ness of it.The patients with low income or low education share the highest rate of non-standard treatment.The part of patient of AS by using etanercept is the most expensive.RA, OA and SLE rank the second.Conclusion The category of rheumatism in Guang-zhou old town area has its own features.The ratio of non-standard treatment is high, which relates to the widespread lack of knowl-edge for rheumatism, less health education, expensive drugs, low income and less communication between doctors and patients.Some constructive measures could be introduced.

关 键 词：风湿病 门诊 治疗 医疗费用 依从性 

分 类 号：R759[医药卫生—皮肤病学与性病学]