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目的了解耐多药患者从确诊为肺结核病到确诊为耐多药肺结核病之间的治疗行为,以及在此期间所获得的管理服务情况。方法采用结构式访谈问卷调查在天津市、黑龙江省大庆市、河南省濮阳市3个项目市专科医院住过院的43位耐多药肺结核患者。运用SPSS 16.0软件对获取的资料进行统计分析。结果 53.5%(23/43)的患者首次抗结核治疗是在结核病防治机构(简称结防机构),37.2%(16/43)的患者首次抗结核没有完成治疗疗程。从确诊为肺结核病到确诊为耐多药肺结核病期间,患者平均治疗天数为767 d,平均费用为24 536元,72.1%(31/43)的患者在2家以上的医疗机构治疗过,23.3%(10/43)的患者存在停药行为,46.5%(20/43)的患者有结核病防治人员访视。结论研究对象的治疗过程复杂、治疗行为不规范,结防机构的管理也不到位。应当加强对患者的引导和管理,提高患者的治疗依从性,防止耐药的产生。
Objectives To understand the therapeutic behavior of MDR-TB patients from diagnosis of tuberculosis to the diagnosis of MDR-TB and the management services obtained during this period. Methods A structured interview questionnaire was used to survey 43 MDR-TB patients who had been hospitalized in three special hospitals in Tianjin, Heilongjiang Daqing and Puyang, Henan Province. Using SPSS 16.0 software for statistical analysis of the data obtained. Results The first anti-TB treatment in 53.5% (23/43) of the patients was at the TB prevention and treatment agency (abbreviated as the anti-TB institution), and 37.2% (16/43) of the patients did not complete the first anti-TB treatment. From the diagnosis of tuberculosis to the diagnosis of MDR-TB, the average number of days of treatment was 767 days, with an average cost of 24,536 yuan. Of those patients, 72.1% (31/43) had been treated in more than two medical institutions and 23.3 % (10/43) of the patients had withdrawal behaviors, and 46.5% (20/43) of the patients had tuberculosis control personnel visits. Conclusions The treatment process of the research object is complicated, the treatment behavior is not standardized, and the management of the prevention and treatment institutions is not in place. Should strengthen the guidance and management of patients to improve patient compliance with treatment to prevent the emergence of drug resistance.