Investigation On The Diagnosis And Treatment Status Of Helicobacter Pylori Infections In Gastroenterologists Of Fujian Province

Objective:In this study,we investigate the status of H.pylori infection in gastroenterology physician of Fujian area.By the analysis of existing problems,we are going to explore the key points of attention in the course of diagnosis and treatment of H.pylori infection in order to improve the standardization of diagnosis and treatment of H.pylori infection.Methods:From August 2016 to December,a questionnaire was designed to investigate the gastroenterologists in Fujian area,including the basic information of physicians and the diagnosis and treatment of H.pylori.According to the difference of hospital levels,physicians have been divided into Class 3-A hospital group(first group)and Non-class 3-A hospital group(second group);According to the difference of titles,physicians have been divided into resident group,physician-in-charge group,deputy chief physician group,chief physician group;According to the difference of economic levels,physicians have been divided into economic developed area group(group A,including Fuzhou,Xiamen,Quanzhou,Zhangzhou)and underdeveloped area group(group B,including Putian,Ningde,Sanming,Longyan,Nanping).SPSS22.0 statistical software was used to carry on the statistical analysis of the collected valid questionnaires,and the statistical methods were Kruskal-Wallis H test and x2 test.Results:(1)Access to H.pylori clinical knowledge: The way for gastroenterologists to get H.pylori clinical knowledge is mainly through the academic conference(89.5%),the professional journal(83.5%),clinical practice(71.5%)and textbook(64.5%).There is no significant difference in the ways of acquiring knowledge among doctors with different titles and different grade of hospital(P>0.05).(2)The diagnosis of H.pylori infection: Urea breath test(UBT)and Rapid urease test(RUT)have been widely used in hospitals at all levels in the Fujian area to detect H.pylori infection,penetration rate were over 80.0%;When the H.pylori detected by fibro gastroscopic biopsy,only a few number of physicians(37.9%)had multiple biopsy,and the physicians proportion of second group is significantly less than that of first group(P<0.05);On the choice of the biopsy site,80.6% physicians chose the antrum.(3)The treatment of H.pylori infection: 68.5% physicians disagree with the statement that all of the H.pylori positive patients should be treated;The proportion of physicians who choose a long course and bismuth quadruple therapy in group A is significantly higher than that of group B(P<0.05),and the proportion of physicians who choose a long course and bismuth quadruple therapy in first group is significantly higher than that of second group(P<0.05).In the rescue therapy,there are 13.6% physicians had repeated use high resistance antibiotics which has been already used in initial treatment;The proportion of physicians in the group A is more than group B to choose the second generations and potent imported PPI,such as esomeprazole、Rabeprazole(P<0.05),there is more proportion of physicians in group B than group A to choose the domestic PPI(P<0.05),the proportion of physician-in-charge who choose domestic PPI is significantly higher than that of residents physician(P<0.05).(4)Doctor-patient communication: 70% physicians always inform patients of potential adverse and the importance of compliance duration eradication of H.pylori;Only 36% physicians always inform patients pay attention to personal hygiene and implementation of separate dining system;Only 22.1% physicians explain the family members of the patients with H.pylori detection.(5)Occupational protection: Only 27% of physicians always pay attention to occupational protection Conclusion:On the whole,the diagnosis and treatment of H.pylori infection in Fujian gastroenterologists is standardized.There are still some irregularities and differences in the endoscopy biopsy,the initial treatment regimen,the course of treatment and the choice of PPI,which concerned with the levels of regional economic and the grades of hospital.For underdeveloped areas group and non-class 3-A hospital group more effort should be made to improve the situations in diagnosis and treatment status of H.pylori infection.In addition,the majority of doctors are still lacking in doctor-patient communication and occupational protection awareness should be further strengthened.