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目的了解2009-2016年湖南省登记肺结核患者来源的分布特征情况。方法从“中国疾病预防控制信息系统结核病管理信息系统”分年度查询下载2009-2016年湖南省肺结核患者登记报告数据。用Excel 2007和SPSS 13.0软件描述和分析不同地区和年份患者来源分布特征及变化趋势。结果 2009-2016年湖南省共登记肺结核患者447 341例,2009-2015年患者发现数趋于平稳,2016年患者发现数稍有下降。2009-2016年登记肺结核患者绝大部分来源于因症就诊、转诊和追踪,共有431 217例,占所有患者的96.4%,这三类患者分别占总病例的41.08%、32.33%和23.00%。2009-2016年各市州患者来源分布差异有统计学意义(χ~2=64 532.912,P=0.000)。岳阳市(55.67%)、邵阳市(52.58%)和张家界市(49.44%)患者来源中均是因症就诊比例最大,占到了登记患者的一半或以上。郴州市(47.53%)、湘潭市(45.46%)、湘西自治州(45.26%)转诊是患者主要来源。长沙患者主要来源于追踪(46.39%)。2009-2016年全省不同年度登记肺结核患者来源差异有统计学意义(χ~2=10 142.484,P=0.000);各年度因症就诊患者比例呈缓慢下降趋势(χ_(趋势)~2=2 434.161,P=0.000);但追踪比例呈逐年上升趋势(χ_(趋势)~2=8 844.858,P=0.000)。结论 2009-2016年湖南省登记肺结核患者主要来源于因症就诊,其次是转诊和追踪,但近几年来因症就诊比例呈下降趋势,追踪比例在逐渐上升,转诊比例也稍有增加;不同市州登记患者来源存在差异。提示在强化健康教育重要性的同时,要加强医防合作,认真落实患者追踪工作,要针对不同市州特点不断优化患者发现方式。
Objective To understand the distribution of the source of registered tuberculosis patients in Hunan Province from 2009 to 2016. Methods The annual report of tuberculosis management information system of China Disease Prevention and Control Information System was used to download the data of 2009-2006 Hunan Province tuberculosis patient registration report. Using Excel 2007 and SPSS 13.0 software to describe and analyze the source distribution characteristics and trends of patients in different regions and years. Results A total of 447 341 cases of pulmonary tuberculosis were registered in Hunan Province from 2009 to 2016. The number of patients found in 2009-2015 tended to be stable and the number of patients in 2016 was slightly decreased. A total of 431 217 cases, accounting for 96.4% of all cases, accounted for 41.08%, 32.33% and 23.00% of the total cases respectively. Most of the patients registered for TB in 2009-2016 were from treatment, referral and follow-up. . There was significant difference in source distribution of patients between cities and prefectures in 2009-2016 (χ ~ 2 = 64 532.912, P = 0.000). The source of disease in Yueyang City (55.67%), Shaoyang City (52.58%) and Zhangjiajie City (49.44%) were the largest, accounting for 50% of the registered patients. Chenzhou City (47.53%), Xiangtan City (45.46%), Xiangxi Autonomous Prefecture (45.26%) referral is the main source of patients. Changsha patients mainly from tracking (46.39%). There was a statistically significant difference in the source of registered TB patients in different years between 2009 and 2016 (χ ~ 2 = 10 142.484, P = 0.000); the proportion of patients with symptomatic treatment showed a slowly decreasing trend in each year (χ_ (trend) ~ 2 = 2 434.161, P = 0.000). However, the follow-up ratio showed an upward trend year by year (χ_ (trend) ~ 2 = 8 844.858, P = 0.000). CONCLUSIONS: Hunan Province registered 2009-2006 patients with tuberculosis mainly due to symptomatic treatment, followed by referral and follow-up, but the proportion of symptomatic treatment showed a downward trend in recent years, the proportion of follow-up was gradually increased, the proportion of referrals also increased slightly; There are differences in the source of registered patients in different municipalities. Prompted the importance of strengthening health education at the same time, we must strengthen medical cooperation, conscientiously implement the patient tracking work, we must continue to optimize the characteristics of different cities to find ways for patients.