山东地区呼吸科医师对支气管扩张症诊治认知的现状调查

Attitudes and practices of respiratory physicians regarding the diagnosis and treatment of bronchiectasis:a questionnaire-based cross-sectional study in Shandong Province,China

目的 评估呼吸科医师对支气管扩张症诊治的认知现状,为推进支气管扩张症管理策略提供参考依据。方法 2020年10月至2022年6月对山东地区143家医院的呼吸科医师围绕“支气管扩张症的诊治”进行问卷调查,比较各级医院及各级职称的呼吸科医师对支气管扩张症的病因鉴别、疾病严重性评估、诊断和治疗等各个方面的认知现状。结果 共608名呼吸科医师完成问卷调查,其中24.7%的医师从未进行体液免疫检测,仅168名(27.6%)医师了解支气管扩张症严重程度评分。三级医院的医师对支气管扩张症病因鉴别以及铜绿假单胞菌清除治疗的认知水平高于二级医院的医师(OR=1.952,95%CI:1.253~3.041,P=0.003;OR=2.495,95%CI:1.543~4.035,P<0.001)。阅读支气管扩张症指南的医师对支气管扩张症病因鉴别以及疾病严重程度评估的认知水平高于未阅读指南的医师(OR=1.725,95%CI:1.027~2.897,P=0.039;OR=2.067,95%CI:1.361~3.138,P=0.001)。结论 山东地区呼吸科医师(尤其二级医院医师)对支气管扩张症管理策略的认知水平仍需加强,需继续推广病因筛查及精简的疾病严重程度评估方法。

Objective To evaluate the attitudes and practices of respiratory physicians regarding the diagnosis and treatment of bronchiectasis,so as to provide reference for promoting the management strategies of bronchiectasis.Methods During Oct.2020 and Jun.2022,a questionnaire survey was conducted among respiratory physicians in 143 hospitals in Shandong Province about the cognition of diagnosis and treatment of bronchiectasis.The cognitive status of physicians at different levels of hospitals and with different professional titles were compared.Results A total of 608 respiratory physicians completed the questionnaire,24.7% of whom never tested humoral immunity,and 27.6% knew about the Bronchiectasis Severity Index.The cognition of bronchiectasis etiology discrimination and Pseudomonas aeruginosa clearance of physicians from tertiary hospitals was significantly higher than that of those from secondary hospitals(OR=1.952,95%CI:1.253-3.041,P=0.003;OR=2.495,95%CI:1.543-4.035,P<0.001).Physicians who had read the bronchiectasis guidelines had a higher cognition than those who had not read the guidelines(OR=1.725,95%CI:1.027-2.897,P=0.039;OR=2.067,95%CI:1.361-3.138,P=0.001).Conclusion The cognition of bronchiectasis management strategies among respiratory physicians,especially those from secondary hospitals in Shandong Province,still needs to be strengthened.It is necessary to continue to promote etiological screening and simplified disease severity assessment methods.