妇产科医师对膀胱过度活动症认知情况调查

Investigation on cognition of overactive bladder among gynecologists

目的调查中国妇产科医师对女性膀胱过度活动症(overactivebladder,OAB)的病因、临床表现、实验室检查及治疗的认知情况。方法于2017年8月至2018年2月通过医院内发放自行设计问卷,对全国23个城市1 061例从事妇科临床工作的医生进行女性OAB相关认知的调查。结果共收回有效调查问卷1 056(99.5%)份。87%(919/1 056)的妇科医生清楚地知道多种妇科疾病常伴有尿急、尿频等OAB症状;41%(433/1 056)不清楚女性OAB的发生与其特殊生理因素有关。在有OAB可能的患者就诊时,约51%(539/1 056)妇科医生不完全清楚女性OAB患者的病史问诊信息;50%(528/1 056)不完全清楚导致女性OAB症状的病因,并且40%(422/1 056)不会对每一例可能出现OAB的患者进行症状问询。83%(876/1 056)不会准确使用膀胱过度活动症状评分(overactive bladder symptom score, OABSS)判断患者OAB症状的严重程度。在OAB的诊断调查中,仅有13%(137/1 056)的妇科医生完全清楚女性OAB患者的筛选性检查项目,7%(74/1 056)完全清楚急迫性尿失禁与混合性尿失禁的区别,76%(803/1 056)认为M受体拮抗剂是OAB的首选药物治疗方案。结论妇产科医师对有关女性OAB的主要症状表现、发病相关的特殊生理因素、常见病因、检查内容、鉴别诊断及治疗方案的认知不强,不能准确使用OABSS判断女性OAB患者的症状严重程度。

Objective To investigate the cognition of etiology, clinical manifestations, laboratory examination and treatment of overactive bladder(OAB) in Chinese gynecologists. Methods From August 2017 to February 2018, a self-designed questionnaire was distributed in hospitals to investigate the OAB-related cognition of 1 061 doctors engaged in gynecological clinic in 23 cities in China. Results A total of 1 056(99.5%) questionnaires were collected, 87%(919/1 056) of gynecologists were clearly aware that a variety of gynecological diseases were often accompanied by OAB symptoms such as urgency and frequency of urination. 41%(433/1 056) were not clear that the occurrence of OAB in women was related to special physiological factors. About 51%(539/1 056) of patients with potential OAB were not fully aware of the medical history information of female OAB patients. 50%(528/1 056) were not fully aware of the cause of OAB symptoms in women. And 40%(422/1 056) did not conduct symptom inquiries in every patient at risk for OAB. 83%(876/1 056) did not accurately assess the severity of OAB symptoms using the OAB diagnostic tool-overactive bladder symptom score(OABSS). Only 13%(137/1 056) were fully aware of screening tests for female OAB patients. 7%(74/1 056) were fully aware of the difference between urge incontinence and mixed incontinence. 76%(803/1056) of gynecologists believed that M-receptor antagonists were the preferred drug treatment for OAB. Conclusion In the investigation, the gynecologists did not have a strong understanding of the main symptoms of the female OAB, specific physiological factors related to the onset, and the common causes. So they cannot accurately use OABSS to determine the severity of symptoms in female OAB patients.