Abstract:

Objective To evaluate the intervention effect on the village doctors after they have been trained about the application of antithrombotic drug to ischemic stroke and explore the effective ways to train the village doctors. Methods Self-designed questionnaire were performed upon 500 village doctors who came from twenty towns in Beiliu city to investigate their recognition of knowledge of using the antithrombotic drug. The village doctors were divided into two groups including the intervention group and the control group. The former received the training while the latter didn't. The training content included the introduction to the types, usage and adverse reaction of the antithrombotic drug and the regulatory application of the antithrombotic drug for secondary prevention. After half a year, a survey with the same questionnaires was made. Comparison between the two groups was made to know the intervention effect. Results The intervention group enrolled 257 village doctors while the control group enrolled 225 village doctors. After having been trained, the village doctors in the intervention group had a better understanding of the knowledge of antithrombotic drug. Compared to the village doctors in the control group, each index of their skills had improved remarkably. The following data could prove that knowing all the four names of antithrombotic drug (29.57% vs 10.20%, P <0001), the knowing rate of four side effects of using antithrombotic drug (50.58% vs 28.00%, P <0001), the knowing rate of using aspirin and clopidogrel correctly (71.60% vs 36.00%, P <0001), the knowing rate of

using antithrombotic drug immediately after stroke (68.48% vs 29.78%, P <0001), the knowing rate of long-term application of antithrombotic drug (76.65% vs 34.67%, P <0001), knowing to apply warfarin anticoagulation to valvular disease (69.65% vs 25.33%, P <0001), and knowing the recurrent embolism and antiplatelet drugs (45.14% vs 26.22%, P <0001). Conclusion The training about the knowledge of the application of antithrombotic drugs to ischemic stroke could improve the village doctors’ skill of using the antithrombotic drugs effectively.

Key words: Ischemic stroke; Antithrombotic drug; Application knowledge; Village doctors;Intervention

摘要：

目的 评价村医对缺血性卒中抗栓药物应用知识干预的效果，探索适合村医的培训办法。 方法 通过自行设计问卷，对北流市20个乡镇500例村医进行缺血性卒中抗栓药物应用知识认知调 查，然后分为干预组和对照组。对干预组进行培训，内容包括：介绍抗栓药物种类、用法、不良反应 及二级预防抗栓药物应用规范。对照组不培训。半年后用相同问卷再调查。比较两组对药物应用知 识了解的效果。 结果 干预组和对照组分别纳入257例和225例村医，干预组干预后对抗栓药物的知识各项指标掌 握均显著增高，如同时知晓4个抗栓药物名称（29.57％ vs 10.20％，P <0.001），4个不良反应的知 晓率（50.58％ vs 28.00％，P <0.001），阿司匹林及氯吡格雷正确用法知晓率（71.60％ vs 36.00％； 61.09％ vs 24.89％），卒中后抗栓药物应立即使用知晓率（68.48％ vs 29.78％，P <0.001），需长 期应用知晓率（76.65％ vs 34.67％，P <0.001），心瓣膜病应用华法林抗凝（69.65％ vs 25.33％， P <0.001），复发性栓塞加抗血小板聚集药物（45.14％ vs 26.22％，P <0.001）等指标均显著高于对 照组。 结论 缺血性卒中抗栓药物应用知识的培训能有效促进村医对抗栓药物规范使用知识的掌握。

关键词: 缺血性卒中; 抗栓药物; 应用知识; 村医; 干预