呼吸科医生对于COPD认知和处理现状的断面调查

Knowledge Level about Prevention and Treatment of COPD:A Cross-Sectional Survey in Pulmonary Physicians

目的了解国内部分城市呼吸科医生对COPD的认知水平，以及COPD的防治现状。方法2006年7～10月，由中国呼吸病专家咨询小组设计调查方案，制订调查提纲，采取横断面调查，分析24家医院，对258名呼吸科医生进行面对面调查，主要内容包括：对COPD认知水平，初诊及复诊COPD患者处方用药情况，监测肺功能情况，对稳定期COPD患者的评估和干预措施，对于常用药物的认识和评价，戒烟的作用及采取的措施，对于COPD治疗前景、效果及患者教育的认识等。结果88％的呼吸科医生自己认为对COPD非常了解，95％的呼吸科医生熟悉COPD病情严重度分级，绝大多数呼吸科医生知晓GOLD和COPD防治指南。对COPD的危害认识比较全面，诊断中重视胸部x线和肺功能检查。对稳定期COPD病情评估标准认识不够统一，92％的呼吸科医生要求COPD患者在稳定期复查肺功能。79％的呼吸科医生积极建议患者戒烟。初诊和复诊时用药方案基本符合指南，但是对于祛痰药评价过高，应用频率也较高。93％的呼吸科医生认为对稳定期COPD进行治疗很有必要，69％的呼吸科医生认为稳定期COPD患者经过治疗可以取得令人满意的生活质量。结论目前国内大城市呼吸科医生对于COPD的认知水平较高，但是对COPD的用药及长期防控干预还有一定差距。

Objectives To evaluate pulmonary physicians＇ knowledge level about prevention and treatment of chronic obstructive pulmonary disease（COPD） in some urban areas in China. Methods A total of 258 pulmonary physicians were interviewed face-to-face in 24 hospitals from July to October in 2006. The questionnaire included the knowledge of COPD, prescriptions at initial visit and follow-up, pulmonary function test monitoring, assessment and intervention in stable COPD, knowledge and evaluation of the commonly used medicines, the effects of smoking cessation and adopted measures, as well as the knowledge of treatment prospects and patients＇ education. Results Eighty-eight percent of pulmonary physicians considered themselves knowledgeable on COPD, and 95% were familiar with the severity classification. Most of them knew about GOLD and Chinese Guideline of Prevention and Treatment to COPD, and paid attention to chest X-ray and pulmonary function test during diagnosis. The standards in evaluation of stable COPD patients were not well understood,and 92% of physicians claimed for pulmonary function test in stable stage. Seventy-nine percent of physicians actively suggested the patients quit smoking. The prescription for COPD patients at iniative and maintenance therapy met the guideline on the whole, but the mucolytic agents were appreciated too much and used too frequently. Thirty-three percent of physicians took it necessary to treat stable COPD, and 69% believed that pharmacotherapy for stable COPD could rersuh in satisfactory quality of life. Conclusions In some big cities in China,the pulmonary physicians have good knowledge about COPD. But long-term prevention and intervention, especially in pharmacotherapy, are still unsatisfactory.