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目的了解曲靖市克山病病情状况和变化趋势,评估克山病防控效果,为预防控制克山病和消除克山病的危害提供科学依据。方法按照“云南省地方病防治项目实施方案”和“全国克山病监测方案(试行)”要求,以《克山病诊断标准》为诊断依据,在曲靖市2个克山病病区县(麒麟区、会泽县)的病区乡(村)进行重点监测。查阅克山病区医疗机构内科、儿科、急诊科近3年出入院登记、门诊及住院的心肌疾病病例,确诊克山病病例。结果 2006-2012年在2个病区县的5个监测村共检测2 523人,检出潜在型克山病7例,检出率为0.28%;2007年和2009年,7~14岁儿童发硒检测结果分别为(0.335±0.210)和(0.262±0.059)mg/kg;心电图检查结果异常180人,异常率为7.13%;胸部X线片检查22例,心胸比例≤0.50的17例,0.51~0.55的5例;对15家医疗机构开展克山病病例搜索,搜出心肌病300例,其中疑似克山病10例,经市、县诊断组专家集体讨论,均排除克山病诊断。结论曲靖市克山病检出率低,检出病例以潜在型克山病为主,今后应加强对低年龄段人群的克山病的监测和干预。
Objective To understand the status and changing trend of Keshan disease in Qujing and evaluate the prevention and control of Keshan disease so as to provide a scientific basis for preventing and controlling Keshan disease and eliminating the harm of Keshan disease. Methods According to the “Implementation Plan of Endemic Disease Prevention Project in Yunnan Province” and “National Keshan Disease Surveillance Program (Trial)”, and based on the diagnostic criteria of “Keshan Disease”, two Keshan disease Ward counties (Kirin District, Huize County) ward township (village) to focus on monitoring. Check Keshan Ward medical institutions, pediatrics, emergency department nearly 3 years out of hospital registration, outpatient and hospitalized cases of myocardial disease, confirmed Keshan disease cases. Results A total of 2 523 people were detected in 5 monitoring villages in 2 ward counties from 2006 to 2012, and 7 cases of potential Keshan disease were detected. The detection rate was 0.28%. In 2007 and 2009, children aged 7 to 14 Selenium test results were (0.335 ± 0.210) and (0.262 ± 0.059) mg / kg; electrocardiogram abnormalities in 180 people, the abnormal rate was 7.13%; chest X-ray examination in 22 cases, cardiothoracic ratio ≤ 0.50 in 17 cases, 0.51 ~ 0.55 in 5 cases; Keshan disease cases were searched in 15 medical institutions, found 300 cases of cardiomyopathy, of which suspected Keshan disease in 10 cases, the city and county diagnosis group of experts to discuss collectively exclude Keshan disease diagnosis . Conclusion The detection rate of Keshan disease in Qujing is low. The detection of Keshan disease in Qujing is mainly based on the potential Keshan disease, and the monitoring and intervention of Keshan disease in the low-age group should be strengthened in the future.