中国15个城市老年科医生门诊下尿路症状认知和诊疗现状调查  

An investigation of the status of geriatric doctors＇ acknowledge and treatment of outpatients with lower urinary tract symptoms in 15 Chinese cities

作　　者：张大磊[1] 刘明[1] 张耀光[1] 魏东[1] 万奔[1] 王建业[1] 

机构地区：[1]北京医院国家老年医学中心泌尿外科,100730

出　　处：《中华老年医学杂志》2017年第5期574-578,共5页Chinese Journal of Geriatrics

摘　　要：目的了解中国老年科医生对门诊下尿路疗状（LUTS）认知和诊疗现状。方法2013年10月至2014年2月在全国15个城市对1056名老年科医生进行LUTS相关行为、态度、技能和知识方面（BASK）的问卷调查，通过了解中国老年科医生对LUTS定义、病因、诊断及治疗现状的认知情况开对结果进行分析讨论，旨在提高参与者对老年LUTS诊疗的认知，强化实践，从而推动老年LUTS诊疗规范化发展、提高老年LUTS临床诊治水平的最终目标。结果定义与病因方面，95．9％的老年科医生认为了解LUTS的主要临床表现，然而，仅34．3％的老年科医生能够对LUTS不同症状进行正确分类；超过90．0%的老年科医生认为了解LUTS是由多种原因所致，并且认为能熟练地判断导致LUTS的常见原因，然而仅38．0％的医生能够完全掌握多种泌尿系统疾病均可导致LUTS，并且只有35．5％的医生会主动对门诊中所有可能能出现LUTS的患者进行症状询问。诊断方面，近70．0％的老年科医生认为熟练地掌握了LUTS／BPH初步诊断评估的路径。然而，调查显示多数老年科医生并未完全遵从指南推荐的诊断评估路径，并且仍有近30．0％老年科医生未能准确使用国际前列腺症状评分（IPSS）对LUTS严重程度进行分类。治疗方面，75．8%的老年科医生认为会在全面评估症状的基础上为老年LUTS／BPH患荇选择最佳的治疗方案。然而，近60．0%的老年学科医生并不清楚α1受体阻滞剂是中重度男性LUTS患者的一线治疗选择，并且在51．0%老年科医生不清楚前列腺体积〈40ml的老年LUTS患者选择α1受体阻滞剂单药治疗即口。82．3％的老年科医生认为合并高血压的老年LUTS患者应分别针对LUTS和高血压进行治疗。然而，在具体药物选择方面，近55．0％的老年科医生不清楚抗高血压和降脂治疗预肪心脏病发作试验（ALLHAT）研究证实的多沙�Objective To investigate the status of geriatric doctors＇ acknowledge and treatment of outpatients with lower urinary tract symptoms in 15 Chinese cities. Methods The investigation was conducted in 15 Chinese cities and involved 1056 geriatric doctors from December 2013 to February 2014. The questionnaire survey was made in Behavior, attitude, skirt and knowledge（ BASK ） of LUTS. The geriatric doctors participated in the investigation by answering the questionnaires about acknowledge for definition, etiology, diagnosis and treatment of the LUTS,and in results discussion, which was aimed at improving participants＇ cognition for diagnosis and treatment of elderly LUTS and at strengthening the practice. The final objective was to promote diagnosis standardization and to improve the lcvel of clinical diagnosis and treatment for the elderly LUTS. Results 95.9% of geriatric doctors considered that they knew well the main clinical manifcstations of LUTS. However, 34.3% of geriatric doctors were able to classify the symptoms of I.UTS correctly. More than 90.0% of geriatric doctors considered that the causes of LUTS were variable and they mastered the common cause of LUTS. But,38.0% of them were able to completely master the causes of LUTS and 35.5% would actively ask outpatients about the symptoms. 70.0% of the doctors thought they were familiar with the inilial manifestations of I.UTS and benign prostatic hypertrophy（BPH）. However, many Chinese geriatric doctors didn＇t follow up the guidelines and 30.0% of them failed to evaluate the severity of LUTS via IPSS（International Prostatic Symptom Score）. 75.8% of geriatric doctors considered that they would give the patients the best treatment options by comprehensive assessment. However,60.0% of them didn＇t know thai α1 receptor blocker was the first line of treatment option of patients with moderate severe LUST. More than half of them were unclear that the patients with prostate volume under 40 ml could be treated by α1 receptor blocker. 82.3% of geria

关 键 词：泌尿系疾病 问卷调查 

分 类 号：R69[医药卫生—泌尿科学]