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丹麦全科医疗中的消化不良。对全科医疗咨询者的1年分析。

Dyspepsia in general practice in Denmark. A 1-year analysis of consulters in general practice.

作者信息

Meineche-Schmidt V, Krag E

机构信息

Department of General Practice, Panum Institute, University of Copenhagen, Denmark.

出版信息

Scand J Prim Health Care. 1998 Dec;16(4):216-21. doi: 10.1080/028134398750002981.

Abstract

OBJECTIVE

To estimate the incidence rate of patients with dyspepsia in general practice, related to age, gender and dwelling and to classify the patients into dyspepsia subgroups.

DESIGN

In a background population of 123,610 persons under the National Health Insurance System a systematic, prospective registration of dyspepsia patients consulting in general practice was done. Each patient was subject to a structured interview covering 18 dyspepsia symptoms and six alarm symptoms. A diagnostic chart was used to classify the patients into subgroups.

SETTING

General practice: 93 general practitioners in 63 centres in Denmark.

PATIENTS

Patients consulting the general practitioner with dyspepsia as their main complaint.

RESULTS

4215 dyspepsia patients were registered within 1 year. The annual incidence rate of dyspepsia was 3.4%. Alarm symptoms were present in 11.7% of the patients. The highest incidence rates were related to middle age, female gender and rural dwelling. Of these 34% had dysmotility-like, 30% had reflux-like, 17% ulcer-like and 3% uncharacteristic dyspepsia, while 16% were classified into two or more groups. Dysmotility-like dyspepsia was predominant in women and reflux-like dyspepsia was predominant in men.

CONCLUSIONS

Within 1 year 34 patients out of 1000 will seek medical advise in general practice with a new episode of dyspepsia. Based on the registration of symptoms 28 of 34 can be classified into a single subgroup of dyspepsia; 4 of 34 patients will present with one or more alarm symptom.

摘要

目的

评估全科医疗中消化不良患者的发病率,分析其与年龄、性别及居住地区的关系,并将患者分为不同的消化不良亚组。

设计

在国家医疗保险系统覆盖的123,610名背景人群中,对全科医疗中因消化不良前来就诊的患者进行系统的前瞻性登记。每位患者都接受了涵盖18种消化不良症状和6种警示症状的结构化访谈。使用诊断图表将患者分为不同亚组。

地点

全科医疗:丹麦63个中心的93名全科医生。

患者

以消化不良为主要诉求前来咨询全科医生的患者。

结果

1年内登记了4215例消化不良患者。消化不良的年发病率为3.4%。11.7%的患者有警示症状。发病率最高的与中年、女性及农村居住有关。其中,34%为动力障碍样消化不良,30%为反流样消化不良,17%为溃疡样消化不良,3%为非特异性消化不良,16%被归为两个或更多组。动力障碍样消化不良在女性中占主导,反流样消化不良在男性中占主导。

结论

在1年内,每1000人中会有34人因新发消化不良在全科医疗中寻求医疗建议。根据症状登记情况,34例中有28例可被归为单一的消化不良亚组;34例患者中有4例会出现一种或多种警示症状。

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