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目的:了解医疗机构外阴阴道假丝酵母菌病过度诊断和过度治疗的现状,为制定外阴阴道假丝酵母菌病标准化、规范化诊断治疗规范提供参考依据,以减少患者的就医成本及医疗资源的浪费。方法:通过对深圳地区综合医院、专科医院、计划生育服务中心和私营医院的93名妇产科医生、皮肤性病科医生、计划生育科医生和检验科医生进行匿名问卷调查,了解他们诊断和治疗外阴阴道假丝酵母菌病的实际操作方法,与临床诊疗操作规程进行对比。结果:①调查医生平均年龄为(38.6±9.3)岁,最小的22岁,最大的61岁;从事医疗工作平均年限为16.3年,文化程度以大专和本科为主,占62.4%,硕士及以上占23.7%,其他学历占13.9%。②39名实验室检验科医生中,29名出现过度诊断,占74.4%。③临床医生诊断过程中,35.2%的医生以实验室诊断作为判断标准,77.8%临床医生出现过度诊断。④77.8%的临床医生会给患者过度治疗用药。⑤在治疗外阴阴道假丝酵母菌病的过程中,对育龄妇女性伴侣的治疗不规范。⑥无症状外阴阴道假丝酵母菌病会影响计划生育手术的进行。结论:临床医生和实验室医生过度医疗情况比较严重,且影响计划生育手术的进行,因此,应加强对临床诊疗工作的规范化管理,减少医疗资源浪费。
OBJECTIVE: To understand the status of over diagnosis and over-treatment of vulvovaginal candidiasis in medical institutions and to provide a reference for the development of standardization and standardization of diagnosis and treatment of vulvovaginal candidiasis in the vulva to reduce the cost of medical treatment and the waste of medical resources . Methods: Anonymous questionnaires were conducted among 93 obstetricians and gynecologists, dermatologists, family planning physicians and laboratory physicians in general hospitals, specialist hospitals, family planning service centers and private hospitals in Shenzhen to find out their diagnosis and treatment Vulvo vaginal candidiasis practical method of operation, and clinical practice procedures for comparison. Results: ① The average age of investigators was (38.6 ± 9.3) years old, the youngest was 22 years old and the maximum was 61 years old. The average life span of medical work was 16.3 years. The educational level was mainly college and undergraduate, accounting for 62.4% Accounting for 23.7%, other qualifications accounted for 13.9%. ② Of the 39 laboratory laboratory doctors, 29 patients had overdiagnosis, accounting for 74.4%. ③ During the diagnosis of clinicians, 35.2% of doctors took laboratory diagnosis as the standard of judgment and 77.8% of clinicians developed excessive diagnosis. ④77.8% of clinicians will give patients over-treatment medication. ⑤ in the treatment of vulvovaginal candidiasis in the process of sexual partners of women of childbearing age treatment is not standardized. ⑥ asymptomatic vulvovaginal candidiasis will affect the progress of family planning surgery. Conclusion: Excessive medical conditions for clinicians and laboratory doctors are more serious and affect the progress of family planning operations. Therefore, the standardized management of clinical diagnosis and treatment should be strengthened to reduce the waste of medical resources.