内科医师对全球哮喘防治倡议知晓情况调查

Investigation of knowledge of Global Initiative for Asthma in physicians

为调查基层内科医师对全球哮喘防治倡议(GINA)的了解及掌握程度,笔者于2020年8月5日至2021年3月16日采用便利抽样的方法对北京大学第三医院延庆医院及其他8家社区医院的194名内科医师进行调查问卷。共发放194份调查问卷,收回有效问卷163份,有效率为84.0%。调查显示,仅有38.7%(63名)的调查对象知道支气管哮喘的病理基础是"气道非特异性炎症",而选择"支气管痉挛"者占52.1%(85名)。选择主要治疗药物为"吸入β2受体激动剂"及"吸入皮质激素"者分别占42.9%(70名)和44.8%(73名)。选择非重症哮喘急性发作时的最佳给药方式为"吸入方式"者占62.6%(102名)。仅有18名(11.0%)调查对象使用过峰流速仪,但能正确使用并记录曲线者仅2名(1.8%),47.9%(78名)的调查对象从未听说过。11.0%(18名)和12.9%(21名)的调查对象在使用糖皮质激素时不知道需"屏气10s"和"含漱咽部2~3次",对每喷间隔时间的正确选择者也仅占63.8%(103名)。63.8%(103名)的调查对象从未听说过GINA方案,执行过GINA方案者仅有5名(3.1%)。可见,基层内科医师对支气管哮喘的新知识、吸入疗法及应用峰流速仪的认识尚存在不足,迫切需要加强GINA方案在基层医院的推广应用。

To investigate the knowledge of the Global Initiative for Asthma(GINA)in physicians,a questionnaire survey was conducted randomly among 194 physicians from Peking University Third Hospital Yanqing Hospital and 8 district hospitals between August 5,2020 and March 16,2021.A total of 194 questionnaires were distributed and 163 valid question aires were collected,with an effective rate of 84.0%.The survey showed that only 38.7%(n =63)of the subjects knew that the pathological basis of asthma is "nonspecific airway inflammation",while 52.1%(n=85)of them chose"bronchospasm".As to the main treatment drugs,42.9%(n=70)chose"inhaled β2 receptor agonists"and 44.8%(n=73)chose"inhaled corticosteroids";62.6%(n=102)chose"inhalation method"as the best way of administration during the acute attack of non-severe asthma.Only18 physicians(11.0%)had ever used the peak flow meter,but only 2(1.8%)could correctly use and record the curve,47.9%(n=78)even had never heard of it.Of the physicians,11.0%(n=18)and 12.9%(n=21)did not know "hold their breath for 10s"and"gargle the pharynx 2 to 3 times"when using glucocorticoids;only 63.8%(n=103)chose the correct choice of the interval between sprays;and 63.8%(n=103)had never heard of the GINA program,and only 5(3.1%)had implemented it.The insufficient understanding of the new knowledge of bronchial asthma,inhalation therapy and application of peak flow meter was found in primary physicians,the promotion and application of GINA program in primary hospitals need to be urgently strengthened.