海南省综合医院医务人员对幽门螺杆菌感染诊疗的认知现状调查  

A survey on the knowledge of Helicobacter pylori infection diagnosis and treatment among medical staff from general hospitals in Hainan Province

作　　者：周慧 陈国宁 郭阳 谭琰 蓝程[5] 吴冬寒 马占良 程芃 莫翠毅 王明 黎培员[10,11] 林崖 杨永强 韩钧凌 陈斋 林昌领 吴朝娜 陈盛雄 陈正义 黄晓曦[1] Zhou Hui;Chen Guoning;Guo Yang;Tan Yan;Lan Cheng;Wu Donghan;Ma Zhanliang;Cheng Peng;Mo Cuiyi;Wang Ming;Li Peiyuan;Lin Ya;Yang Yongqiang;Han Junling;Chen Zhai;Lin Changling;Wu Zhaona;Chen Shengxiong;Chen Zhengyi;Huang Xiaoxi(Department of Gastroenterology,Haikou Hospital Affiliated to Central South University Xiangya School of Medicine(Haikou General Hospital),Haikou 570208,China;Department of Geratology,Ding′an Hospital of Traditional Chinese Medicine,Ding′an 571200,China;Department of Gastroenterology,Lingshui Li Autonomous People′s Hospital,Lingshui 572400,China;Department of Gastroenterology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Gastroenterology,Hainan Province General Hospital,Haikou 570311,China;Department of Gastroenterology,Sanya People′s Hospital,Sanya 572000,China;Department of Gastroenterology,Chengmai County People′s Hospital,Chengmai 571900,China;Department of Gastroenterology,Hainan Western Central Hospital,the Western Branch of Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Danzhou 571799,China;Department of Gastroenterology,Qionghai People′s Hospital,Qionghai 571400,China;Department of Gastroenterology,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Gastroenterology,Wenchang People′s Hospital,Wenchang 571300,China;Department of Gastroenterology,Wanning People′s Hospital,Wanning 571500,China;Department of Gastroenterology,928th Hospital of Joint Service Support Force of the Chinese PLA,Haikou 570206,China;Department of Gastroenterology,Dongfang People′s Hospital,Dongfang 572600,China;Department of Gastroenterology,Changjiang Li Autonomous People′s Hospital,Changjiang 572700,China;Department of Gastroenterology,Ledong Li Autonomous People′s Hospital,Ledong 572500,China;Department of Gastroenterology,Qiongzhong Li and Miao Autonomous People′s Hospital,Qiongzhong 572900,China;Department of Gastroenterology,Shanghai N

机构地区：[1]中南大学湘雅医学院附属海口医院(海口市人民医院)消化内科,海口570208 [2]定安县中医院老年病科,定安571200 [3]陵水黎族自治县人民医院消化内科,陵水572400 [4]海南医学院第一附属医院消化内科,海口570102 [5]海南省人民医院消化内科,海口570311 [6]三亚市人民医院消化内科,三亚572000 [7]澄迈县人民医院消化内科,澄迈571900 [8]海南西部中心医院上海交通大学医学院附属第九人民医院西部分院消化内科,詹州571799 [9]琼海市人民医院消化内科,琼海571400 [10]华中科技大学同济医学院附属同济医院消化内科,武汉430030 [11]文昌市人民医院消化内科,文昌571300 [12]万宁市人民医院消化内科,万宁571500 [13]解放军联勤保障部队第九二八医院消化内科,海口570206 [14]东方市人民医院消化内科,东方572600 [15]昌江黎族自治县人民医院消化内科,昌江572700 [16]乐东黎族自治县人民医院消化内科,乐东572500 [17]琼中黎族苗族自治县人民医院消化内科,琼中572900 [18]上海交通大学医学院附属第九人民医院消化内科,上海200003

出　　处：《中华消化杂志》2024年第4期223-233,共11页Chinese Journal of Digestion

基　　金：海南省自然科学基金高层次人才项目(823RC603);海南省卫生健康行业科研项目(20A200456、22A200319)。

摘　　要：目的了解海南省综合医院医务人员对《第六次全国幽门螺杆菌感染处理共识报告(非根除治疗部分)》(以下简称国六共识)和《2022中国幽门螺杆菌感染治疗指南》(以下简称指南)的认知与应用现状。方法2023年2月20日至5月7日对海南省15家综合医院共1463名医务人员进行幽门螺杆菌(H.pylori)感染诊疗相关的问卷调查。调查问卷结合国六共识与指南拟定,包括对H.pylori及H.pylori相关性疾病的认知,对H.pylori检测的认知,以及对H.pylori根除、预防方法、根除影响因素的认知等6大版块。统计学方法采用卡方检验。结果共回收有效问卷1463份,问卷有效率为100.00%。1463名调查对象包括225名消化内科医师与1238名其他岗位医务人员(包括503名其他内科医师,264名外科医师,471名医技药学医务人员)。78.67%(177/225)的消化内科医师认为我国H.pylori总体感染率>20%,认知率高于其他岗位医务人员[其他内科65.41%(329/503)、外科61.74%(163/264)、医技药学60.30%(284/471),以下数据均以此岗位排序],差异有统计学意义(χ^(2)=30.97,P<0.001)。51.11%(115/225)的消化内科医师认为H.pylori血清学抗体检测不可以作为现症感染的诊断方法,认知率高于其他岗位医务人员[22.07%(111/503)、14.02%(37/264)、12.31%(58/471)],差异有统计学意义(χ^(2)=152.66,P<0.001)。关于质子泵抑制剂和钾离子竞争性酸阻滞剂在尿素呼气试验前应停用2周、抗菌药物和铋剂应停用4周,消化内科医师的认知率均高于其他岗位医务人员[38.67%(87/225)比23.26%(117/503)、19.70%(52/264)、18.47%(87/471),60.89%(137/225)比26.64%(134/503)、25.76%(68/264)、23.78%(112/471)],差异均有统计学意义(χ^(2)=133.70、165.51,均P<0.001)。对于难治性H.pylori感染,98.67%(222/225)的消化内科医师认同进行细菌培养和抗菌药物药敏试验或耐药基因检测指导下的H.pylori感染个体化诊治,认知率高于其他岗位医务人员[91.85%(46Objective To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection(treatment excluded)(hereinafter referred to as sixth national consensus)and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment(hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan.Methods From February 20 to May 7,2023,a questionnaire survey on the diagnosis and treatment of Helicobacter pylori(H.pylori)infection was conducted among 1463 medical staff from 15 general hospitals in Hainan Province.The questionnaire was drawn up according to the sixth national consensus and the guideline,covering knowledge of 6 sections,induding H.pylori related diseases,detection of H.pylori,eradication,prevention and influence factors of eradication of H.pylori,etc.Chi-square test was used for statistical analysis.Results A total of 1463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1463 subjects included 225 gastroenterologists and 1238 other medical staff(including 503 physicians from other departments,264 surgeons and 471 medical technologists and pharmacists).About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H.pylori in China was more than 20%,the awareness rate was higher than that of other medical staff(physicians from other departments 65.41%(329/503),surgeons 61.74%(163/264),medical technologists and pharmacists 60.30%(284/471);the following datas were sorted by this position),and the difference was statistically significant(χ^(2)=30.97,P<0.001).About 51.11%(115/225)of gastroenterologists considered that H.pylori serological antibody test could not be used as a diagnostic method for current infection,the awareness rate was higher than that of other medical staff(22.07%(111/503),14.02%(37/264),12.31%(58/471)),and the difference was statistically significant(χ^(2)=152.66,P<0.001).Proton pump inhibitor and potassium-competitive acid bl

关 键 词：螺杆菌 幽门 认知 共识 调查和问卷 医师 海南 

分 类 号：R57[医药卫生—消化系统]