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男性住院医师的性别或症状特异性行为?对门诊腹痛女性和男性患者诊断与治疗的分析

[Sex- or symptom-specific behavior of male residents? An analysis of diagnosis and therapy of ambulatory female and male patients with abdominal pain].

作者信息

Conen D, Kuster M

机构信息

Medizinische Universitäts-Poliklinik, Kantonsspital Basel.

出版信息

Soz Praventivmed. 1988;33(3):167-72. doi: 10.1007/BF02078425.

Abstract

We investigated the influence of the patient's gender for diagnostic and therapeutic approach of physicians at the outpatient clinic of the university hospital of Basle. In a prospective study 13 male residents in their second and third year of medical training were observed in their management of 25 female and 25 male patients presenting with the leading complaint of abdominal pain with regard to taking of the medical history, the physical examination and the performed diagnostic and therapeutic procedures, without informing the participating physicians. The time spent for the first consultation and the number of follow ups performed were registered. Following differences in the management of female and male patients were observed: The time spent at the first consultation was 59 +/- 5 minutes in female and 45 +/- 3.5 in male patients (p less than 0.03). Fundoscopic examination was three times more often performed in female patients. Endoscopic examinations were more often observed in male patients (p less than 0.01). Antacids and H2-antagonists were more frequently prescribed in male (p less than 0.01). Spasmolytics and laxatives more frequently in female (p less than 0.01). In summary in male patients the diagnosis of functional disease was predominantly made after exclusion of an organic disease what does explain the use of more diagnostic procedures and the induction of a more specific therapy.

摘要

我们在巴塞尔大学医院的门诊研究了患者性别对医生诊断和治疗方法的影响。在一项前瞻性研究中,观察了13名处于医学培训第二和第三年的男性住院医师对25名女性和25名男性患者的诊治情况,这些患者均以腹痛为主诉,研究过程中未告知参与的医生。记录了首次会诊所用时间以及后续随访的次数。观察到在对女性和男性患者的诊治方面存在以下差异:女性患者首次会诊用时59±5分钟,男性患者为45±3.5分钟(p<0.03)。女性患者进行眼底检查的频率是男性患者的三倍。男性患者接受内镜检查的情况更为常见(p<0.01)。抗酸剂和H2拮抗剂在男性患者中的处方频率更高(p<0.01)。解痉药和泻药在女性患者中使用更频繁(p<0.01)。总之,在男性患者中,功能性疾病的诊断主要是在排除器质性疾病之后做出的,这解释了为何使用了更多的诊断程序并采用了更具针对性的治疗方法。

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