The prevalence of proctological symptoms amongst patients who see general practitioners in France.
The prevalence of proctological symptoms amongst patients who see general practitioners in France.
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DOI：
10.3109/13814788.2014.899578
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发表时间：
2014-12
期刊：
影响因子：
--
通讯作者：
Laouénan C
中科院分区：
文献类型：
--
作者：
Abramowitz L;Benabderrahmane M;Pospait D;Philip J;Laouénan C
患者不经常讨论肛门症状，导致直肠疾病诊断较晚并影响健康。流行病学知识匮乏是造成这种情况的一个因素，这可能是普通医学中的一个重大问题。作者通过评估有多少直肠疾病是自发诊断的以及有多少是在询问患者后确诊的，从而评估了家庭医生在直肠疾病中的作用。 39 名全科医生完成了一份有针对性的调查问卷，以评估 2.5 天咨询期间预期就诊的所有患者。总共完成了 1079 份问卷，其中女性 621 份 (58%)，男性 458 份 (42%)，平均年龄 54 岁。22 名患者 (2%) 主要因肛门症状就诊。经过询问，153 名患者（14%）发现了肛门症状。报告的症状包括：出血（32%）、疼痛（31%）、肛门瘙痒（22%）、肿胀（22%）、渗血（14%）和肛门分泌物（14%）。医生的诊断是：痔疮、肛裂、肛门分泌物、皮肤病、功能障碍。 35% 的患者仅通过询问来做出这些诊断。肛门失禁是与转诊至专科医生相关的唯一因素（OR = 5；95% CI：1.4–17.8）。直肠病学在普通人群中的作用似乎很重要。在六分之五的病例中，患者隐瞒了肛门症状。未经检查的患者出现肛门症状的比例很高可能是由多种因素造成的。需要进一步的研究来识别这些问题并改进肛门疾病的诊断和治疗。
Patients do not often discuss anal symptoms, resulting in late diagnosis of proctological disorders and impacting health. Poor epidemiological knowledge is a contributing factor to this, which can be a significant problem in general medicine. Authors evaluated the role of family doctors in proctological disorders by assessing how many of these are spontaneously diagnosed and how many are diagnosed after questioning the patient. Thirty-nine general practitioners completed a targeted questionnaire to assess all patients seen prospectively over 2.5 days of consultations. A total of 1079 questionnaires were completed, 621 (58%) for females and 458 (42%) for males with a median age of 54. Twenty-two patients (2%) were seen primarily for anal symptoms. Following questioning, an anal symptom was found in 153 patients (14%). Symptoms reported were: bleeding (32%), pain (31%), pruritus ani (22%), swelling (22%), oozing (14%), and anal discharge (14%). Physicians’ diagnoses were: haemorrhoids, anal fissure, anal discharge, dermatology disease, and functional disorder. In 35% of patients, questioning alone was used to make these diagnoses. Anal incontinence was the only factor associated with referral to a specialist (OR = 5; 95% CI: 1.4–17.8). The role of proctology in the general population appears to be significant. In five out of six cases, patients conceal anal symptoms. The high proportion of unexamined patients with anal symptoms is probably multifactorial. Further studies are needed to identify these and put in place the improvement of diagnosis and treatment of anal disorder.
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影响因子：
3.9
作者：
Abramowitz, Laurent;Benabderrahmane, Dalila;Duval, Xavier
通讯作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
1.8
作者：
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