Dyspeptic symptoms in primary care. An observational study in general practice
Dyspeptic symptoms in primary care. An observational study in general practice
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DOI：
10.1097/00042737-200209000-00009
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发表时间：
2002-09-01
影响因子：
2.1
通讯作者：
Corinaldesi, R
中科院分区：
文献类型：
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作者：
Maconi, G;Tosetti, C;Corinaldesi, R
背景和目的消化不良经常导致患者咨询全科医生，但通常在转诊中心进行调查。本研究介绍了消化不良的特点和它的关系，人口，临床和社会经济因素的患者看到的全科医生在意大利. Patients和方法在意大利，10 000名全科医生被要求招募多达10个连续消化不良患者在1个月的时间。疼痛和无痛消化不良症状、胸骨后疼痛/烧灼感a、id可见腹胀通过经验证的问卷进行0 - 3级评分。还记录了人口统计学和临床特征。结果测试期间，共纳入43446例患者（55%为男性; 50%年龄在45岁以上; 49%为吸烟者; 45%出现症状时间大于或等于1个月; 28%有消化性溃疡病史）。消化不良占参与医生咨询的8.3%（范围3 - 11%）。分别有84%和79%的患者报告上腹痛和饱胀。69%的患者消化不良症状为中度至重度（分级大于或等于2）。分别有21%和25%的病例报告了主要上腹痛和主要不适。男性、吸烟、夜间觉醒、重叠反流症状和消化性溃疡病史在以疼痛为主的患者中更常见，而女性和重叠腹胀在以不适为主的患者中更常见。年龄、教育程度和工作状况与任何症状模式无关。年轻患者首次提出与简单的消化不良占10%的消化不良workload.Conclusions消化不良占全科医生的相关工作量。消化道症状之间存在相当大的重叠。根据目前的指南，可以凭经验治疗的患者比例可能低于预期。(C)2002年利平科特威廉姆斯威尔金斯。
Background and aims Dyspepsia frequently causes patients to consult a general practitioner, but is generally investigated in referral centres. This study describes features of dyspepsia and its relationship with demographic, clinical and socio-economic factors in patients seen by general practitioners in Italy.Patients and methods In Italy, 10 000 general practitioners were asked to recruit up to 10 consecutive dyspeptic patients during a 1-month period. Painful and non-painful dyspeptic symptoms, retrosternal pain/burning a,id visible abdominal distension were graded 0-3 by a validated questionnaire. Demographics and clinical features were also recorded.Results During the test period, 43 446 patients were included (55% were men; 50% were over 45 years old; 49% were smokers; 45% had experienced symptoms for greater than or equal to 1 month; 28% had a history of peptic ulcer). Dyspepsia accounted for 8.3% (range 3-11%) of the consultations of a subset of participating doctors. Epigastric pain and fullness were reported in 84% and 79% of patients, respectively. Dyspeptic symptoms were moderate-severe (graded greater than or equal to 2) in 69% of patients. Predominant epigastric pain and predominant discomfort were reported in 21% and 25% of the cases, respectively. Male gender, smoking, nocturnal awakening, overlapping reflux symptoms and a history of peptic ulcer were more frequent in patients with predominant pain, while female gender and overlapping abdominal distension were more common in patients with predominant discomfort. Age, educational level and working status were not related to any symptom pattern. Young patients presenting for the first time with uncomplicated dyspepsia accounted for 10% of the dyspepsia workload.Conclusions Dyspepsia accounts for a relevant workload for general practitioners. A considerable overlap exists among digestive symptoms. The proportion of patients that can be empirically treated according to current guidelines may be lower than expected. (C) 2002 Lippincott Williams Wilkins.