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目的掌握吉林省大骨节病病情现状和消长趋势,科学评估防控措施效果,发现问题,总结经验,提高吉林省大骨节病控制及监测水平。方法按照全国大骨节病监测方案的要求,在选取的4个监测县中各选4个病区村为监测点。临床检查监测点7～16岁的全部儿童患病情况,7～12岁儿童右手X线阳性检查及13～16岁临床诊断Ⅰ度及以上病人X线检查。同时收集该病区县、乡、村的相关基本资料。结果吉林省共16个监测点。16个监测点临床共检查1 262人,检出临床I度病人6例,6例临床患者经X线拍片诊断全部排除。7～12岁儿童X线拍片873人,确诊X线阳性7例,均为单纯干骺端改变,平均X线检出率为0.8%,未检出骨端和三联征患者。全省X线检出率没有超过10%的病区村,检出率均在5%以下。在防治措施落实方面,4个病区县近3年没有供应硒碘盐(或口服硒片),未实施病区村搬迁及异地育人。松源市前郭县、延边州安图县、通化梅河口市实行了退耕还林(草)。4个病区县病区村全部实施非国家统一的换粮方式(市场外购),受益人口85.09万人。在监测的4个病区县16个病区村中,居民主食主要为大米,其中10个病区村购食外地粮食比例超过50%。结论吉林省自实行以改水为主的综合防治措施后,病情开始下降。随着经济条件的改善,生活水平的提高,居民以食大米为主,且食用外购粮的比例较高;此外,饮水和卫生条件的改善,肉、蛋等副食种类增加也提高了机体对疾病的抵抗能力,使病情得到有效控制并处于稳定状态。
Objective To grasp the status of FKD in Jilin Province and its trend of growth and decline, to scientifically evaluate the effect of prevention and control measures, find out the problems, summarize the experience and improve the control and monitoring of KBD in Jilin Province. Methods According to the requirements of Kashin-Beck disease monitoring program in the country, 4 ward villages in 4 selected monitoring counties were selected as monitoring points. Clinical examination monitoring point of all children aged 7 to 16 prevalence of disease, 7 to 12-year-old children right X-ray examination and 13 to 16-year-old clinical diagnosis of Ⅰ degree and above X-ray examination. At the same time collect the ward county, township and village related basic information. Results A total of 16 monitoring points in Jilin Province. A total of 1 262 people were examined in 16 monitoring sites, 6 cases were found with clinical I degree, and 6 cases were all excluded by X-ray film diagnosis. X-ray filming of 7 ~ 12-year-old children 873 people, diagnosed X-positive in 7 cases, were simple metaphyseal changes, the average X-ray detection rate of 0.8%, not detected in patients with bone ends and triads. The province’s X-ray detection rate of no more than 10% of ward villages, the detection rate of 5% or less. In the implementation of prevention and treatment measures, no selenium iodized salt (or oral selenium tablets) was supplied to the four ward counties for the past three years, and no relocation of ward villages and education were carried out in different places. Songyuan County, Songyuan County, Antu County, Yanbian, Tonghua Meihekou City, the implementation of the conversion of farmland to forests (grass). All 4 ward counties and ward villages all implemented the non-state unified food exchange (market outsourcing), benefiting a population of 850,900. Among the 16 ward villages monitored in the 4 ward counties, residents mainly used rice as their staple food, of which 10 ward villages purchased more than 50% of the food in other places. Conclusion Jilin Province started to decline after implementing comprehensive prevention and treatment measures based on water improvement. With the improvement of economic conditions, the improvement of living standards, residents mainly eat rice, and eat a higher proportion of food purchased; In addition, drinking water and sanitation improved, meat, eggs and other non-staple food increased also increased the body Disease resistance, so that the disease was effectively controlled and in a stable state.