北京成人急性腹泻的诊治与指南存差距(英文)

Management of acute diarrhea in adults in hospitals in Beijing did not adhere well to Manatsathit working party guidelines

临床医师诊治成人急性腹泻是否遵照指南不曾调查过。本研究目的旨在评估北京成人急性腹泻的诊治与腹泻诊治指南的一致性。2011年5月–6月在北京10家综合医院进行了腹泻诊治调查。400例患者接受调查,平均年龄(35.5±14.8)岁,52.3%为女性。所有患者中,357例(89.3%)表现为水样腹泻,43例(10.7%)表现为脓血便。在357例水样腹泻患者中,114例(31.9%)患者没有给予补液治疗,186例(52.1%)患者给予了抗生素治疗,而有抗生素应用指证的患者仅有28例(7.8%,年龄大于65岁或有免疫缺陷病)。这种处理完全背离了指南。止泻剂仅用于7例水泻患者,与指南基本一致。北京综合医院对成人腹泻的诊治与指南存有差距,需加强腹泻诊治培训。

How hospital physicians adhere to guidelines on management of diarrhea in adults has not been adequately assessed. The purposes of this study were to evaluate the management of acute diarrhea in adults and to assess the adherence of hospital physicians to the Manatsathit working party recommended guidelines. A cross sectional survey was carried out during May to July 2011 among physicians in 10 hospitals in Beijing, China. Data were collected for 400 patients （208 females and 192 males） with the mean age of （35.54-14.8） years. Overall, 357 （89.3%） patients presented with watery diarrhea and 43 （10.7%） patients presented with bloody diarrhea. Of 357 patients who needed fluid and electrolyte therapy, however, up to 114 （31.9%） patients were not ordered any fluid and electrolyte replacement; although only 28 （7.8%） actually supposed to use the antibiotics due to an age of higher than 65 years or being immunologically compromised, however, 186 （52.1%） were prescribed antibiotics which significantly deviated from the guidelines recommended by the Manatsathit working party. Antimotility drugs were only used in seven patients with watery diarrhea, which was in line with the guidelines. Hospital physicians in Beijing did not adhere well to the guidelines for the management of acute diarrhea. Physicians might need to be refreshed on the guidelines in this specific field.