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目的了解结防门诊肺结核病人发现的主要方式,建立可持续病人发现模式,同时为针对不同的人群采取不同的健康教育方式提供理论依据。方法对2004-2009年的初诊登记本资料进行分析。结果 2004-2009年结防机构共登记初诊病人8 191例,确诊肺结核病人4 601例,涂阳病人1 677例;其中转诊、就诊和其他三种方式发现的肺结核病人分别占肺结核病人总数的64.7%、30.4%和4.9%;三种方式来源的病人中肺结核病人和涂阳病人的检出率分别为54.5%、57.1%和54.3%(χ2=5.175,P=0.075),35.5%、37.5%和28.0%(χ2=8.973,P=0.011),不同来源病人中两种检出率均无明显差异;不同级别医疗机构转诊到位病人中肺结核病人和涂阳病人的检出率有明显差异。结论转诊仍是结防机构发现肺结核病人的主要方式,尤其是市级及以上医疗机构,但就诊也占一定的比例。因此在病人发现上,除了加强对医疗机构进行归口管理外,对大众人群结防政策和知识的宣传仍不可松懈。
OBJECTIVE To understand the main ways of detecting tuberculosis patients in outpatient clinics and to establish a pattern of sustainable patient discovery and to provide a theoretical basis for different health education methods for different populations. Methods 2004-2009 initial registration information for analysis. Results From 2004 to 2009, 8 191 cases of newly diagnosed cases were registered with the anti-tuberculosis agencies, 4 601 cases of tuberculosis were diagnosed, and 1 677 cases of smear-positive patients were diagnosed. Among them, the total number of cases of tuberculosis found by referral, treatment and other three methods 64.7%, 30.4% and 4.9% respectively. The detection rates of pulmonary tuberculosis patients and smear positive patients in the three ways were 54.5%, 57.1% and 54.3% respectively (χ2 = 5.175, P = 0.075) % And 28.0% respectively (χ2 = 8.973, P = 0.011). There was no significant difference in the detection rates of two kinds of patients from different origins. The detection rates of pulmonary tuberculosis patients and smear positive patients were significantly different . Conclusion The referral is still the main method for TB patients to find out tuberculosis patients, especially those at municipal level or above, but the consultation also accounts for a certain proportion. Therefore, in the discovery of patients, in addition to strengthening the centralized management of medical institutions, publicity on public policy on prevention and knowledge of the crowd can not be loosened.