安徽省专科医护人员对幽门螺杆菌感染诊疗的认知及应用情况调查
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摘要
目的了解安徽省专科医护人员对"第五次全国幽门螺杆菌(Helicobacter pylori,Hp)感染处理共识报告"(简称"第五次共识")的认知及应用情况。方法 2018年5月—10月对安徽省消化科医生、全科医生和消化科护士共1 200人进行调查问卷。问卷内容有5个方面:对"第五次共识"的了解和应用情况(9个问题)、Hp根除指征判断(6个问题)、Hp检测(8个问题)、Hp根除治疗的方法(5个问题)和Hp根除治疗的筛查及负面影响(3个问题)。结果共收回有效问卷1 125份,问卷有效率93.75%(1 125/1 200)。消化科医生、全科医生和消化科护士对"第五次共识"知晓率分别为80.43%(226/281)、55.95%(329/588)、27.34%(70/256),差异有统计学意义(χ~2=152.956,P<0.001)。91.10%(256/281)消化科医生、68.20%(401/588)全科医生和67.19%(172/256)消化科护士(χ~2=58.679,P<0.001)认为"证实有Hp感染"是Hp根除治疗适应证。结论安徽省专科医护人员在Hp诊治工作中没有完全应用"第五次共识",全科医生和消化科护士相对消化科医生更薄弱,需要进一步加强专科医护人员对共识的学习和应用。
Objective To survey the cognition and application of Helicobacter pylori(Hp) infection among medical specialist in Anhui. Methods From May 2018 to October 2018, a questionnaire survey was conducted among 1 200 medical specialist in Anhui, including 281 gastroenterologists(GI), 588 general practitioners(GP), and 256 gastroenterology nurses(GN). There were 5 parts in the questionnaire, including the knowledge and performance of the Consensus(9 questions), the indications of Hp eradication(6 questions), detection methods of Hp(8 questions), the therapy of Hp eradication(5 questions) and how to treat the screening and negative effects of Hp eradication therapy(3 questions). Results Total 1 125 valid questionnaires were received with a response rate of 93.75%(1 125/1 200). The awareness rate of the Consensus in GI, GP and GN groups was 80.43%(226/281), 55.95%(329/588) and 27.34%(70/256), respectively(χ~2=152.956, P<0.001). Ninety-one point one zero percent(256/281) GI, 68.20%(401/588) GP and 67.19%(172/256) GN groups considered that "confirmed Hp infection" was the indications of Hp eradication therapy, respectively(χ~2=58.679, P<0.001). Conclusion The fifth consensus has not been fully applied to the clinical diagnosis and treatment by medical specialist in Anhui Province. Gastroenterologists are more likely to adhere with the Consensus than general practitioners and gastroenterological nurses in the management of Hp infection. We need to further strengthen the learning and applicating of medical specialist on consensus.
Objective To survey the cognition and application of Helicobacter pylori(Hp) infection among medical specialist in Anhui. Methods From May 2018 to October 2018, a questionnaire survey was conducted among 1 200 medical specialist in Anhui, including 281 gastroenterologists(GI), 588 general practitioners(GP), and 256 gastroenterology nurses(GN). There were 5 parts in the questionnaire, including the knowledge and performance of the Consensus(9 questions), the indications of Hp eradication(6 questions), detection methods of Hp(8 questions), the therapy of Hp eradication(5 questions) and how to treat the screening and negative effects of Hp eradication therapy(3 questions). Results Total 1 125 valid questionnaires were received with a response rate of 93.75%(1 125/1 200). The awareness rate of the Consensus in GI, GP and GN groups was 80.43%(226/281), 55.95%(329/588) and 27.34%(70/256), respectively(χ~2=152.956, P<0.001). Ninety-one point one zero percent(256/281) GI, 68.20%(401/588) GP and 67.19%(172/256) GN groups considered that "confirmed Hp infection" was the indications of Hp eradication therapy, respectively(χ~2=58.679, P<0.001). Conclusion The fifth consensus has not been fully applied to the clinical diagnosis and treatment by medical specialist in Anhui Province. Gastroenterologists are more likely to adhere with the Consensus than general practitioners and gastroenterological nurses in the management of Hp infection. We need to further strengthen the learning and applicating of medical specialist on consensus.
引文
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[4] 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组,刘文忠,谢勇,等.第四次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2012,17(10):832-837.
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[8] 中华医学会消化病学分会幽门螺杆菌和消化性溃疡学组,全国幽门螺杆菌研究协作组,刘文忠,等.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2017,56(7):532-545.
[9] 杨丽卡,潘勤聪,沈强,等.上海市医务人员对幽门螺杆菌感染诊疗的认知情况调查[J].中华全科医师杂志,2017,16(12):930-936.
[10] 胡丽燕,方年富.护理干预对根治幽门螺杆菌的影响[J].现代医药卫生,2013,29(21):3242,3244.
[11] 乔亚琴,于舒芃,翟卫春,等.儿童幽门螺杆菌感染性相关疾病的研究进展[J].湖南中医药大学学报,2018,38(9):1082-1088.
[12] FORD A C,FORMAN D,HUNT R H.Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals:systematic review and meta-analysis of randomized controlled trials[J].BMJ,2014,348:g3174.
[13] 中华消化杂志编委会.消化性溃疡病诊断与治疗规范(2013年,深圳)[J].全科医学临床与教育,2014,12(3):243-246.
[14] 张磊,许建明.幽门螺杆菌感染处理共识解读及实施意见[J].安徽医学,2016,37(11):1319-1323.
[15] XIE C,LU N H.Clinical management of helicobacter pylori Infection in China[J].Helicobacter,2015,20(1):1-10.
[16] XIE Y,ZHU Y,ZHOU H,et al.Furazolidone-based triple and quadruple eradication therapy for Helicobacter pylori infection[J].World J Gastroenterol,2014,20(32):11415-11421.
[17] CHEN Q,ZHANG W,FU Q,et al.Rescue therapy for helicobacter pylori eradication:a randomized nonInferiority trial of amoxicillin or tetracycline in bismuth quadruple therapy[J].Am J Gastroenterol,2016,111(12):1736-1742.
[18] SHIOTANI A,CEN P,GRAHAM D Y.Eradication of gastric cancer is now both possible and practical[J].Semin Cancer Biol,2013,23(6 Pt B):492-501.
[19] 杨淼,胡菁华.老年反流性食管炎临床诊治及内镜分析[J].中国实用医药,2018,13(26):54-56.
[20] 刘文忠.如何看待根除幽门螺杆菌的负面影响[J].中华消化杂志,2017,37(3):164-166.
[2] LEJA M,AXON A,BRENNER H.Epidemiology of Helicobacter pylori infection[J].Helicobacter,2016,21(Suppl 1):3-7.
[3] PLUMMER M,DE MARTEL C,VIGNAT J,et al.Global burden of cancers attributable to infections in 2012:a synthetic analysis[J].Lancet Glob Health,2016,4(9):e609-616.
[4] 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组,刘文忠,谢勇,等.第四次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2012,17(10):832-837.
[5] SUGANO K,TACK J,KUIPERS E J,et al.Kyoto global consensus report on Helicobacter pylori gastritis[J].Gut,2015,64(9):1353-1367.
[6] FALLONE C A,CHIBA N,VAN ZANTEN S V,et al.The toronto consensus for the treatment of helicobacter pylori infection in adults[J].Gastroenterology,2016,151(1):51-69.
[7] MALFERTHEINER P,MEGRAUD F,O’MORAIN C A,et al.Management of helicobacter pylori infection-the maastricht V/Florence consensus report[J].Gut,2017,66(1):6-30.
[8] 中华医学会消化病学分会幽门螺杆菌和消化性溃疡学组,全国幽门螺杆菌研究协作组,刘文忠,等.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2017,56(7):532-545.
[9] 杨丽卡,潘勤聪,沈强,等.上海市医务人员对幽门螺杆菌感染诊疗的认知情况调查[J].中华全科医师杂志,2017,16(12):930-936.
[10] 胡丽燕,方年富.护理干预对根治幽门螺杆菌的影响[J].现代医药卫生,2013,29(21):3242,3244.
[11] 乔亚琴,于舒芃,翟卫春,等.儿童幽门螺杆菌感染性相关疾病的研究进展[J].湖南中医药大学学报,2018,38(9):1082-1088.
[12] FORD A C,FORMAN D,HUNT R H.Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals:systematic review and meta-analysis of randomized controlled trials[J].BMJ,2014,348:g3174.
[13] 中华消化杂志编委会.消化性溃疡病诊断与治疗规范(2013年,深圳)[J].全科医学临床与教育,2014,12(3):243-246.
[14] 张磊,许建明.幽门螺杆菌感染处理共识解读及实施意见[J].安徽医学,2016,37(11):1319-1323.
[15] XIE C,LU N H.Clinical management of helicobacter pylori Infection in China[J].Helicobacter,2015,20(1):1-10.
[16] XIE Y,ZHU Y,ZHOU H,et al.Furazolidone-based triple and quadruple eradication therapy for Helicobacter pylori infection[J].World J Gastroenterol,2014,20(32):11415-11421.
[17] CHEN Q,ZHANG W,FU Q,et al.Rescue therapy for helicobacter pylori eradication:a randomized nonInferiority trial of amoxicillin or tetracycline in bismuth quadruple therapy[J].Am J Gastroenterol,2016,111(12):1736-1742.
[18] SHIOTANI A,CEN P,GRAHAM D Y.Eradication of gastric cancer is now both possible and practical[J].Semin Cancer Biol,2013,23(6 Pt B):492-501.
[19] 杨淼,胡菁华.老年反流性食管炎临床诊治及内镜分析[J].中国实用医药,2018,13(26):54-56.
[20] 刘文忠.如何看待根除幽门螺杆菌的负面影响[J].中华消化杂志,2017,37(3):164-166.