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Annals of Nuclear Medicine and Molecular Imaging

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篇名 某教學醫院臨床醫師對肺造影偵測肺栓塞症的認知及態度調查研究
卷期 15:3
並列篇名 A Survey of the Knowledge and Attitude on Pulmonary Embolism Detection with Lung Scanning among Clinical Physicians in a Teaching Hospital
作者 程紹智楊久騰樊裕明陳群互余明德楊世平
頁次 119-127
關鍵字 肺造影認知態度肺栓塞症lung scanattitudeknowledgepulmonary embolism
出刊日期 200209

中文摘要

背景:本研究藉著問卷調查,了解某教學普院相關科醫師封核醫肺造影偵;如l肺栓塞症的認知與態度,以達到核醫部改進肺造影偵測肺栓塞症的目的。

方法:針對20位主治、16位住院及24位第二年之實習醫師發出60份問卷。問卷內容共30題,包括6題簡答對肺在栓塞症的基本認識,12題是非 對核醫肺臟通氣及灌注造影的概念及12題勾還對核醫部肺造影偵測肺栓塞症的看法O我們囑咐受訪者只依直覺,不刻意翻閱相關資料作答。

結果:有效回收問卷53份,回收率約889毛(53/60)。大部份的受訪醬師認為一個長期臥床、有呼吸困難症狀、呼吸加速、胸部X光有肺浸;閃現象、心電圖出現SjQ3T3、實驗室檢查主見動脈血氧分壓下降及D-dimers濃度上升的病患最有可能罹患肺栓塞症;對核醫肺造影檢查的適應症、條件限制及禁忌等的認知情形相對較差;有13位受訪者對核聲部肺造影偵測肺栓塞症覺得不滿意,主要原因在於結果報告有太多的中或低度可能性肺栓塞症。

結論:受訪醫師對國內月市中全塞症忠者的臨床特徵普遍認為與國外相同,因此可能忽略掉一些非典型徵候的病忠;核醫部須主動、適時地提供各科醫師有關肺造影偵測肺桂塞症的資訊,以加深其對肺造影的認識;繕打肺造影偵測肺才全塞症報告時,儘量給予較明確的答案,乃推動肺造影檢查的最有效途徑。

英文摘要

Background: We surveyed through a questionnaire, the knowledge and attitude on pulmonary embolism (PE) detection with lung scanning among clinical physicians in a teaching hospital. The main purpose of this study was to improve the service models of lung scan in detection PE of the Department of Nuclear Medicine.

Methods: A questionnaire was distributed to 60 clinical physicians (24 intern, 16 resident and 20 attending). The questionnaire consisted of 30-question including 6 essays for the basic knowledge of PE, 12 true or false for the concepts of lung ventilation and perfusion scintigraphy and 12 choices for the attitude on PE detection with lung scanning. We asked the physicians that they had no references, but completed the questionnaire directly.

Results: Fifty-three physicians participated in this study. The response rate was about 88% (53/60). Most of the respondents thought that a patient with being bedridden, dyspnea, tachypnea, lung infiltration on chest radiography, S,Q3T3 pattern on electrocardiogram, hypoxemia and rising D-dimers concentration in laboratory tests was the most possible a victim of PE. In general, the respondents were not aware of the indications, restrictions, and contraindications of lung scan well; thirteen of them had no feeling of satisfaction in PE detection with lung scanning and the major cause was lots of reports with intermediate or low probability of PE on lung scan.

Conclusions: The clinical physicians of our hospital might miss some patients who had PE with atypically clinical symptoms and signs because they commonly thought the patients with PE in Taiwan were not different from other series. In order to make a positive impression of lung scan in detection PE on them, the staffs of Nuclear Medicine have to supply some information to them automatically. The reporters of Nuclear Medicine had better give the appliers a more definite answer when describing the results of lung scan and this is the best way to ask the clinical physicians to apply lung scan.

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