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目的探讨《大骨节病控制和消除考核验收办法》(送审稿)的科学性和可行性,评价四川省汶川县、茂县、小金县、泸定县、冕宁县和青川县6县大骨节病防治效果。方法对6个县所有病区村的全部7~12岁儿童开展临床和右手正位X线检查,收集整理病区基本情况,大骨节病防治措施落实情况及历年大骨节病资料。经自查评估具备病区控制或消除标准的县,逐级向卫生行政部门提出考核验收申请,省级卫生行政部门接到考核验收申请后,组织省级考核验收组对申请县开展考核验收。结果 6县共对15个乡(镇)29个村的2041名7~12岁儿童进行了临床检查和X线拍片,无临床病例,X线阳性2例,均为干骺端改变,平均阳性率0.10%;组织管理考评得分均大于60分(满分80分),防治措施现场考评得分均为50分(满分)。省级考核验收组抽取6个县11个乡(镇)16个村的911名7~12岁儿童和161户家庭开展病情和防治措施落实情况复核工作,复核结果与县级自查结果相符。结论 6县大骨节病病区达到消除,《大骨节病控制和消除考核验收办法》(送审稿)中对组织管理和防治措施的评分条目还有待进一步完善。
Objective To explore the scientificity and feasibility of “Kashin-Beck disease control and elimination of examination and acceptance” (draft for review), to evaluate the prevalence of KBD in 6 counties in Wenchuan County, Maoxian County, Xiaojin County, Luding County, Mianning County and Qingchuan County in Sichuan Province Control effect. Methods Clinical and right-handed orthodontic X-ray examination was performed on all 7-12-year-old children in all ward villages in 6 counties. The basic condition of ward, the implementation of prevention and treatment measures of Kashin-Beck disease and the history of Kashin-Beck disease were collected. After checking and assessing the counties that have ward control or elimination criteria, they will apply for examination and acceptance to the administrative department of health one after another. After the provincial administrative department of health receives the application for examination and acceptance, it will organize the provincial examination and acceptance team to conduct examination and acceptance on the application county. Results A total of 2041 children aged 7-12 years old from 29 villages in 15 townships (towns) were examined by X-ray and film. There were no clinical cases and 2 cases of X-ray positive changes in the 6 counties, all of them were metaphyseal changes with an average of positive Rate of 0.10%; organizational management evaluation scores were greater than 60 points (out of 80 points), prevention and control measures on-site assessment scores were 50 points (out of points). The provincial examination and acceptance team selected 911 children aged 7-12 years and 161 families from 16 villages in 11 townships (towns) of 6 counties to review the implementation of the disease and control measures, and the results of the review were consistent with the self-examination results at the county level. Conclusion Six Kashin-Beck disease wards have been eliminated. The scoring entries on organizational management and prevention and control measures in “Measures for the Control and Elimination of Kashin-Beck Disease” (submitted for review) have yet to be further improved.