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目的:对嘉兴市2003-2013年医防合作效果作初步评估,为进一步完善医防合作肺结核病防治体系及制定肺结核病防治对策提供参考依据。方法:实行“疾病预防控制机构负责规划管理、医疗机构负责初筛转诊、定点医疗机构负责确诊治疗、基层医疗卫生机构负责患者的全程随访管理”的新型结核病治疗管理模式。结果:复治涂阳数占总涂阳数从2003年的17.02%下降至2013年的8.48%,未查痰人数逐年下降,2011年以来的查痰率都达到了100%,转诊到位率从2003年的62.79%上升到2013年的88.99%,追踪到位率从2003年的58.20%上升到2013年的84.31%,总体到位率从2003年的84.45%上升到2013年的98.27%,治愈率从2003年的80.95%逐步上升到2013年的90.96%,11年间平均治愈率达到87.21%。结论:通过“实施定点医疗机构—疾病预防控制机构—社区卫生服务中心”的医防合作模式,进一步完善了三级防痨网络,实行了规范化诊治、转诊追踪、随访管理的有机结合,提高了肺结核病的治愈率,减少结核的传播。
OBJECTIVE: To evaluate the effect of medical cooperation between 2003 and 2013 in Jiaxing City, and to provide reference for further improving the prevention and control system of medical cooperation and cooperation in tuberculosis prevention and treatment. Methods: To implement the new TB treatment management mode in which “institutions for disease control and prevention are in charge of planning and management, medical institutions are responsible for primary screening and referral, designated medical institutions are responsible for diagnosis and treatment, and grassroots medical and health institutions are responsible for patients’ full follow-up management.” Results: The number of smear positive cases decreased from 17.02% in 2003 to 8.48% in 2013. The number of unaccounted sputum decreased year by year, and the sputum sampling rate reached 100% since 2011. The referral rate From 62.79% in 2003 to 88.99% in 2013, the tracking rate has risen from 58.20% in 2003 to 84.31% in 2013, and the overall penetration rate has risen from 84.45% in 2003 to 98.27% in 2013. The cure rate From 80.95% in 2003 to 90.96% in 2013, the average cure rate reached 87.21% in 11 years. CONCLUSION: The three-level anti-tuberculosis network has been further improved and the organic combination of standardized diagnosis and treatment, referral tracking and follow-up management has been further improved through the medical cooperation model of “implementing the designated medical institutions - disease prevention and control institutions - community health service centers” , Improve the cure rate of tuberculosis and reduce the spread of tuberculosis.