影响慢性前列腺炎治疗方法的因素：韩国泌尿外科医生的全国性调查

Ku Ja Hyeon, Paick Jae-Seung, Kim Soo Woong

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

Int J Urol. 2005 Nov;12(11):976-83. doi: 10.1111/j.1442-2042.2005.01165.x.

BACKGROUND

We investigated the influence of physicians' attitudes on the treatment of chronic prostatitis, and attempted to correlate demographic and professional characteristics with patterns of therapy regarding chronic prostatitis.

METHODS

Probability samples were drawn from the Korean Urological Association Registry of Physicians, and a random sample of 850 Korean urologists were asked to complete a questionnaire which explored practice characteristics, attitudes, and diagnostic and treatment strategies for the management of chronic prostatitis. The returned questionnaires were statistically analysed.

RESULTS

Of the 850 questionnaires sent, 302 were returned, and 275 of those were included in the final analysis (response rate 32.4%). Multivariate logistic regression analysis indicated that the type of hospital (P < 0.001) and belief that culture tests helped diagnose chronic prostatitis (P = 0.001) were the most determinant factors with respect to the routine performance or non-performance of culture tests. Most Korean urologists (96.4%) prescribed antibiotics for the primary treatment of chronic prostatitis. Even when primary antibiotic treatment was unsuccessful, urologists frequently prescribed a second course of antibiotics (57.8%). In the multivariate model used, the likelihood of prescribing antibiotics as a secondary treatment varied by the type of hospital, with 0.4-fold odds (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.21-0.87; P = 0.019) of the practice occurring in university hospitals, as opposed to primary clinics. According to the same model, the belief that culture tests help to diagnose chronic prostatitis was also an independent influencing factor (OR, 2.29; 95% CI, 1.39-3.77; P = 0.001), whereas the actual performance of culture tests had no statistical significance.

CONCLUSION

Our findings suggest that the personal beliefs and professional characteristics of physicians may influence the diagnosis and treatment of chronic prostatitis in Korea.

背景

我们研究了医生的态度对慢性前列腺炎治疗的影响，并试图将人口统计学和专业特征与慢性前列腺炎的治疗模式相关联。

方法

从韩国泌尿外科学会医生登记处抽取概率样本，随机抽取850名韩国泌尿科医生，要求他们填写一份问卷，该问卷探讨了慢性前列腺炎管理的实践特征、态度以及诊断和治疗策略。对回收的问卷进行统计分析。

结果

在发出的850份问卷中，有302份被退回，其中275份被纳入最终分析（回复率32.4%）。多因素逻辑回归分析表明，医院类型（P<0.001）以及认为培养检查有助于诊断慢性前列腺炎（P = 0.001）是关于培养检查常规执行与否的最具决定性的因素。大多数韩国泌尿科医生（96.4%）将抗生素作为慢性前列腺炎的主要治疗药物。即使初次抗生素治疗不成功，泌尿科医生也经常会开第二疗程的抗生素（57.8%）。在使用的多因素模型中，作为二线治疗开具抗生素的可能性因医院类型而异，大学医院进行这种治疗的可能性是基层诊所的0.4倍（优势比[OR]，0.43；95%置信区间[CI]，0.21 - 0.87；P = 0.019）。根据同一模型，认为培养检查有助于诊断慢性前列腺炎也是一个独立的影响因素（OR，2.29；95%CI，1.39 - 3.77；P = 0.001），而培养检查的实际执行情况没有统计学意义。