关键词: 全科医生, 经皮冠状动脉介入术后患者, 社区治疗, 浦东新区

Abstract: Objective　To investigate the general practitioners’ treatment for patients after PCI in Pudong New Area,so as to explore the deficiencies in community treatment and ways of improvement.Methods　From July to September 2014,after stratifying in accordance with the located regions （urban,suburban and rural areas） of community health service centers in Pudong New Area,4 community health service centers were randomly selected from each layer,and from these centers,363 general practitioners（GPs） with clinical experience of more than two years were investigated by self-developed questionnaire based on Chinese Percutaneous Coronary Artery Intervention Guidelines 2012.The questionnaire covered three areas:drug therapy,treatment of concomitant diseases,follow-up and health education.A total of 363 questionnaires were handed out and 362 valid ones were recovered with an effective response rate of 99.7%.Results　Drug therapy:the ratio of aspirin prescribed by 160（44.2%） GPs was 31%～60%;190（52.5%）GPs heard of clopidogrel,but did not know its role;238（65.7%）GPs had not heard of dual antiplatelet therapy;the ratio of statins prescribed by 170（46.0%）GPs was more than 60%;238（65.7%）GPs did not know the target value of LDL-C;the ratio of β-blockers prescribed by 296（81.8%）GPs was 10%～30%;the ratio of ACEI/ARB prescribed by 318（87.8%） GPs was 10%～30%.The differences in prescription ratios of aspirin,statins,β-blockers and ACEI/ARB,degree of understanding clopidogrel,dual antiplatelet therapy and target value of LDL-C among GPs with different professional and technical titles showed statistically significance （P<0.05）.Treatment of concomitant diseases:150（41.4%）GPs would first prescribe β-blockers and/or ACEI/ARB for patients with concurrent hypertension;226（62.4%）GPs would strictly control other risk factors for those with concurrent diabetes.The differences in the choice of drugs for the treatment of concurrent hypertension and strict control of other risk factors for the treatment of concurrent diabetes between GPs with different professional and technical titles showed statistically significance （P<0.05）.Follow-up and health education:260（71.8%）GPs advised patients to stop smoking in the first visit,only 1（0.4%）GP could do so in each visit.The differences in the propaganda of tobacco control for smoking patients between GPs with different professional and technical titles were statistically significant （P<0.05）.For regular assessment of the patients’ clinical and prognostic conditions,239（66.0%）GPs selected laboratory examination,356（98.3%）GPs selected electrocardiogram,65（18.0%）GPs selected echocardiography,21（5.8%）GPs selected exercise testing.The differences in the choice of laboratory examination and electrocardiogram for regularly assessing the patients’ conditions between GPs with different professional and technical titles were statistically significant（P<0.05）,while those in the choice of electrocardiogram and exercise testing were not（P>0.05）.Conclusion　The GPs in Pudong New Area manage well in the prescription ratio of aspirin and statins in the PCI postoperative treatment,but poorly in other drugs,treatment of concomitant diseases,propaganda of tobacco control and regular assessment suggested by the guideline of PCI,therefore,they need to further study the guideline and actively study the new progress and theories related to coronary artery disease.

Key words: General practitioners, Patients after percutaneous coronary intervention, Community treatment, Pudong New Area