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目的了解新疆阿勒泰市新型结核病防治服务体系工作进展情况,为完善新型结核病防治服务体系提供科学依据。方法根据定点医院(阿勒泰地区人民医院)各类结核病登记本和统计监测资料,分析新型结核病防治服务体系实施后患者发现、追踪、治疗管理等各项数据。结果 2012年6月—2013年6月未实施新疆结核病防治服务体系,综合医疗机构报告(不包括疾病预防控制中心就诊可疑肺结核病患者)可疑肺结核病患者195例,转诊到位73例(37.43%),追踪到位80例(65.57%),总体到位153例(78.46%);到位患者拍胸片153例(100.00%),痰涂片检查153例(100.00%),阳性检出率43.79%,发现活动性肺结核病患者114例,初治涂阳患者67例,初治涂阴患者35例,复治涂阳患者12例;自2013年6月8日以后阿勒泰地区人民医院(定点医院)共报告可疑肺结核病患者242例,到位228例,转诊到位率19.29%,追踪到位率80.70%,总体到位率94.20%;到位结核病患者拍胸片224例(98.24%),痰涂片检查228例(100.00%),阳性检出率10.76%,发现活动性肺结核患者131例,涂阳患者24例,涂阴患者105例,复治2例,两组总体到位(χ2=4.91)和痰涂片检查结果(χ2=319.49)差异均有统计学意义(P<0.05)。结论新型结核病防治服务体系实施以来患者到位率明显提高,痰涂片阳性检出率有所下降,政策支持与经济补偿是顺利实施新型结核病防治服务体系建设的重要前提。
Objective To understand the progress of the new tuberculosis prevention and treatment service system in Altay, Xinjiang and to provide a scientific basis for improving the new tuberculosis prevention and treatment service system. Methods According to the data of all kinds of TB registration and statistical monitoring in the designated hospital (Altay Regional People’s Hospital), the data of patient discovery, follow-up and treatment management after the implementation of the new TB prevention and treatment service system were analyzed. Results 195 cases of suspicious pulmonary tuberculosis were reported in the report of the integrated medical institutions (excluding those from the CDC) from June 2012 to June 2013, 73 cases (37.43%) were referred to the tuberculosis prevention and treatment system in Xinjiang, ), Followed up in 80 cases (65.57%) and 153 cases (78.46%) in total; 153 cases (100.00%) were in the right chest radiograph and 153 cases (100.00%) were sputum smear. The positive rate was 43.79% Found that 114 patients with active pulmonary tuberculosis, smear-naïve patients in 67 cases, naive smear-negative patients in 35 cases, retreatment of smear-positive patients in 12 cases; since June 8, 2013 after the Altay Regional People’s Hospital 242 cases of suspected tuberculosis were reported, 228 cases were in place, the referral rate was 19.29%, the follow-up rate was 80.70% and the overall rate was 94.20%; 224 cases (98.24%) of tuberculosis patients were located and 228 cases of sputum smear examination (100.00%), the positive detection rate was 10.76% .It was found that there were 131 active tuberculosis patients, 24 smear positive patients, 105 smear negative patients and 2 retreatment patients. The two groups were overall in place (χ2 = 4.91) and sputum smear The test results (χ2 = 319.49) were statistically significant differences (P <0.05). Conclusion Since the implementation of the new tuberculosis prevention and treatment service system, the patients’ arrival rate has been significantly improved, and the positive detection rate of sputum smear has decreased. Policy support and economic compensation are the important preconditions for the successful implementation of the new tuberculosis prevention and treatment service system.