切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 148 -151. doi: 10.3877/cma.j.issn.1674-0785.2018.03.005

所属专题: 文献

临床研究

农村社区医师对房颤诊疗的认知现况调查
沈亚红1, 王彩红2, 魏勇3,(), 欧阳平3   
  1. 1. 201607 上海市松江区泖港镇社区卫生服务中心
    2. 201605 上海市松江区新浜镇社区卫生服务中心
    3. 201600 上海市松江区中心医院心内科
  • 收稿日期:2017-08-05 出版日期:2018-02-01
  • 通信作者: 魏勇

Knowledge of rural community physicians on diagnosis and treatment of atrial fibrillation

Yahong Shen1, Caihong Wang2, Yong Wei3,(), Ping Ouyang3   

  1. 1. Maogang Community Health Service Center, Songjiang District, Shanghai 201607, China
    2. Xinbang Community Health Service Center, Songjiang District, Shanghai 201605, China
    3. Department of Cardiology, Shanghai Songjiang Central Hospital, Shanghai 201600, China
  • Received:2017-08-05 Published:2018-02-01
  • Corresponding author: Yong Wei
  • About author:
    Corresponding author: Wei Yong, Email:
引用本文:

沈亚红, 王彩红, 魏勇, 欧阳平. 农村社区医师对房颤诊疗的认知现况调查[J/OL]. 中华临床医师杂志(电子版), 2018, 12(03): 148-151.

Yahong Shen, Caihong Wang, Yong Wei, Ping Ouyang. Knowledge of rural community physicians on diagnosis and treatment of atrial fibrillation[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(03): 148-151.

目的

调查农村社区医师对心房颤动(房颤)疾病及其抗凝治疗的认识水平。

方法

2015年对上海市松江区7家农村社区卫生服务中心的128名临床医师进行问卷调查,内容包括社区医师对房颤疾病的认识、社区医师对房颤抗凝治疗的认识、社区医师继续教育情况调查。分析被调查者目前对房颤的认知现状。

结果

87.5%(112/128)的社区医师能正确回答房颤是一种心律失常。7.8%(10/128)的社区医师不了解房颤的心电图特征。82.8%(106/128)的社区医师选择中风是房颤的最常见的并发症。未能掌握房颤典型体征的社区医师占4.7%(6/128)。67.2%(86/128)的社区医师认为抗凝治疗对于大多数房颤患者是必不可少的。在房颤患者的首选抗凝药物上,43.8%(56/128)的社区医师认为是阿司匹林,52.5%(67/128)首选华法林和3.9%(5/128)首选氯吡格雷。12.5%(16/128)的社区医师能了解和熟练地使用房颤患者的脑卒中危险分层。7.8%(10/128)的社区医师能够很好地了解和正确评估抗凝血相关的出血风险。42.2%(54/128)的农村社区医师在近3年内没有接受房颤相关的医学继续教育,50.0%(64/128)的社区医师没有关注房颤诊疗指南的更新,65.6%(84/128)的社区医师未曾阅读过房颤诊疗指南,32.0%(41/128)的社区医师在过去的3年中没有接受任何心血管疾病相关的医学继续教育。

结论

农村社区医师对于房颤抗凝治疗的认识存在严重不足,他们接受的房颤相关的医学继续教育也比较匮乏。

Objective

To make a survey of the knowledge of rural community physicians on atrial fibrillation (AF) and antithrombotic therapy.

Methods

A questionnaire survey was conducted in 128 community physicians from seven rural community health service centers in Songjiang District, Shanghai in 2015. The knowledge of community physicians on AF, antithrombotic therapy for AF, and their continuing medical education status were investigated.

Results

Of all community physicians enrolled, 87.5% (112/128) answered correctly that AF was an arrhythmia, 7.8% (10/128) did not understand the electrocardiographic characteristics of AF, 82.8% (106/128) chose stroke as the most common complication of AF, and 4.7% (6/128) failed to describe the typical signs of AF; 67.2% (86/128) believed that antithrombotic therapy was essential for most AF patients; 43.8% (56/128) preferred aspirin, 52.5% (67/128) preferred warfarin, and 3.9% (5/128) preferred clopidogrel as the first-line antithrombotic drug for most AF patients; 12.5% (16/128) could understand and skillfully use the risk stratification of stroke in AF patients, and 7.8% (10/128) could well understand and correctly assess the bleeding risk of anticoagulation. In the past 3 years, 42.2% (54/128) of rural community physicians did not receive continuing medical education related to AF, 50.0% (64/128) paid no attention to AF guideline update, 65.6% (84/128) had not read AF guidelines, and 32.0% (41/128) did not receive any continuing medical education on cardiovascular disease.

Conclusion

There is a serious lack of knowledge on the anticoagulant therapy for AF among rural community physicians, and their continuing medical education related to AF is insufficient.

[1]
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS [J]. Eur Heart J, 2016, 37(38): 2893-2962.
[2]
中华医学会心血管病学分会,中国老年学学会心脑血管病专业委员会,中国生物医学工程学心律分会, 等. 心房颤动抗凝治疗中国专家共识 [J]. 中华内科杂志, 2012, 51(11): 916-921.
[3]
孙艺红,胡大一. 非瓣膜病心房颤动患者全球抗凝注册研究-中国亚组基线数据分析 [J]. 中华心血管病杂志, 2014, 42(10): 846-850.
[4]
Patel P, Pandya J, Goldberg M. NOACs vs. Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation [J]. Cureus, 2017, 9(6): e1395.
[5]
ACTIVE Writing Group of the ACTIVE Investigators, Connolly S, Pogue J, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial [J]. Lancet, 2006, 367(9526): 1903-1912.
[6]
Heidenreich PA, Solis P, Estes NA, et al. 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American college of cardiology/American heart association task force on performance measures [J]. J Am Coll Cardiol, 2016, 68(5): 525-568.
[7]
周自强,胡大一,陈捷, 等. 中国心房颤动的流行病学研究 [J]. 中华内科杂志, 2004, 43(7): 491-494.
[8]
Sjögren V, Byström B, Renlund H, et al. Non-vitamin K oral anticoagulants are non-inferior for stroke prevention but cause fewer major bleedings than well-managed warfarin: a retrospective register study [J]. PLoS One, 2017, 12(7): e0181000.
[9]
Kirchhof P, Schroeder S, European Society of Cardiology Cardiovascular Roundtable. NOACs in Atrial Fibrillation [J]. Eur Heart J, 2017, 38(31): 2382-2385.
[1] 孔令梅, 徐晓媛, 马丽颖. 慢性阻塞性肺疾病认知衰弱危险因素及预后分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 407-410.
[2] 丁镇涛, 邢博涵, 曲洋, 王泊江, 张培训. 老年肱骨近端骨折的围手术期治疗策略[J/OL]. 中华肩肘外科电子杂志, 2024, 12(04): 292-294.
[3] 张骞, 唐伟, 刘丽丽. 右美托咪定复合羟考酮对老年经皮椎间孔镜腰椎间盘切除术患者术后认知功能、镇痛效果的影响[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(04): 209-214.
[4] 吉莉, 苏云楠, 王斌, 沈滔, 刘团结, 毛蕾, 徐玉萍, 张婷, 王博. 急性缺血性脑卒中患者脑白质微结构改变对长期认知功能损伤的预测价值研究[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(04): 193-200.
[5] 付明鹏, 牛国栋, 岑志富, 乔宇, 郭金锐, 郭雨龙, 谢阳, 刘晨, 袁华苑, 刘可, 何姗姗. 三维标测系统指导下国产花瓣状脉冲电场消融系统应用一例[J/OL]. 中华心脏与心律电子杂志, 2024, 12(03): 180-184.
[6] 孙琴, 梁钿苑, 张源, 任亦星. 代谢异常型肥胖患者对肥胖和减重手术的认知调查研究[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 295-299.
[7] 欧春影, 李晓宾, 郭靖, 朱亮, 许可, 王梦, 安晓雷. 丁苯酞对血管性认知障碍大鼠炎症因子的影响及对认知障碍的改善作用[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 483-487.
[8] 郑屹, 刘莹, 张煜坤, 李广平, 陈康寅, 刘彤. 既往及新发心房颤动对急性心肌梗死患者远期卒中风险的影响[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 406-417.
[9] 王丽娜, 吕书霞, 李亚男. 脑卒中偏瘫患者健康焦虑元认知与疾病接受度、恐惧疾病进展的相关性[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 434-440.
[10] 克地尔牙·马合木提, 胡波, 杨琼, 闫素, 胡岚卿, 高沛沛, 姚恩生. 依达拉奉右莰醇对急性脑梗死后认知功能障碍的疗效观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 459-466.
[11] 董立羚, 王添艺, 毛晨晖, 姜宇涵, 尚丽, 包嘉璐, 仇宇悦, 褚珊珊, 金蔚, 倪俊, 高晶. 非出血型脑淀粉样血管病的认知特征——来自北京协和医院痴呆队列的数据[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 295-300.
[12] 周雅萍, 洪月慧, 苏宁, 刘暴, 朱铁楠, 倪俊. 脑淀粉样血管病合并易栓状态的临床治疗决策[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 338-344.
[13] 李芳, 戴西望, 王凯, 郭廷昊, 涂江龙. 非瓣膜性心房颤动相关性卒中的治疗研究进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 393-397.
[14] 董坤, 陈海恋, 王景. 血清CircRNA_0003694与老年急性缺血性卒中患者卒中后认知损害的关系[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(03): 230-235.
[15] 欧春影, 李晓宾, 郭靖, 许可, 王梦, 安晓雷. hs-CRP、Lp-PLA2和S100β与缺血性脑小血管病患者认知障碍的相关性[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(03): 265-269.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?