王碧炯　孙士芳　李冰等

[摘要] 目的 了解城乡全科医师对慢性阻塞性肺病基本概念、诊断与治疗等方面的认知状况，为基层医院全科医师的继续医学教育提供依据。 方法 对21所城区社区卫生服务中心（A组）和27所乡村社区卫生服务中心（B组）的全科医师进行有关慢性阻塞性肺病知识问卷调查，问卷内容涉及慢性阻塞性肺病基本概念、诊断方法、分组诊断、稳定期治疗、急性加重期治疗等五个方面。 结果 A、B两组全科医师对上述五个问卷问题的答对率分别为25.89%、17.26%、5.58%、4.06%、18.78%和8.97%、8.55%、5.13%、4.27%、17.52%，其中，A、B两组全科医师对慢性阻塞性肺病基本概念、诊断方法答对率比较差异有统计学意义（χ2=21.99，P<0.05和χ2=7.41，P<0.05）。 结论 城乡全科医师对慢性阻塞性肺病认知状况较差，对慢性阻塞肺病的防治工作非常不利，亟需在城乡全科医师中加强对《慢性阻塞性肺病诊治指南》的继教工作。

[关键词] 全科医师；慢性阻塞性肺病；问卷调查

[中图分类号] R563.9 [文献标识码] B [文章编号] 1673-9701（2015）21-0104-04

[Abstract] Objective To understand the cognitive level of urban and rural general practitioners in the concept， diagnosis and treatment of chronic obstructive pulmonary disease and to provide the basis for continuing medical education in basic level hospital for all general practitioners. Methods General practitioners from 21 urban community health service centers （group A） and 27 of the rural community health service centers （group B） were surveyed on chronic obstructive pulmonary disease knowledge through a anonymous questionnaire， the survey contents included five aspects of chronic obstructive pulmonary disease such as basic concept， diagnosis， grouping diagnosis， treatment on stable phase and acute exacerbation. Results The correct rates of five questions in group A were 25.89%， 17.26%， 5.58%， 4.06%， 18.78 and in group B were 8.97%， 8.55%， 5.13%， 4.27 %， 17.52%. In chronic obstructive pulmonary disease concept and diagnosis， there was significant difference between two groups（χ2=21.99， P<0.05 and χ2=7.41， P<0.05） . Conclusion The level of the cognitive of COPD（chronic obstructive pulmonary disease） among the general practitioners is very poor， and is strong against to the management work of chronic obstructive pulmonary disease. We need more continuing medical education on "the guidelines on diagnosis and treatment of chronic obstructive pulmonary disease " among the urban and rural general practitioners.

[Key words] General practitioner； Chronic obstructive pulmonary disease； Questionnaire

慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）是一种可防可治的常见呼吸道疾病，其特征为气流受限，是严重影响中老年人生活质量的慢性气道阻塞性疾病。世界卫生组织（WHO）资料显示COPD死亡率有逐年增加的趋势[1]。在国外即使患者教育非常成熟，仍然存在患者的自我认知不足[2]。在中国40岁以上成年人中COPD的患病率为8.2%[3]，患者本身对慢性阻塞性肺病认知度不高[4，5]，因此慢性阻塞性肺病又是一种极易漏诊的疾病，在局部地区，慢性阻塞性肺病漏诊率高达90%[6]。为了解城乡全科医师对慢性阻塞性肺病的认知状况，本课题组对部分城乡社区卫生服务中心全科医师进行有关慢性阻塞性肺病认知的问卷调查，以了解全科医师对慢性阻塞性肺病基本概念、诊断、治疗等方面的认识。……