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目的探讨独立式宣教与管理模式在活动性肺结核患者中的应用,为肺结核患者管理提供理论依据。方法将2013年在玉林市结核病防治所诊断并登记治疗的545例活动性肺结核患者纳入研究,按照1:1的比例,交替归入干预组和内对照组,将2013年在北流市疾病预防控制中心结核门诊诊断并登记治疗的608例活动性患者归入外对照组。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 2013年玉林市共登记并治疗活动性肺结核患者545例,成功治疗率为85.14%(464/545),登记治疗的农村肺结核患者465例,成功治疗率为84.09%(391/465);2013年北流市登记并治疗活动性肺结核患者608例,成功治疗率为71.22%(433/608),登记治疗的农村肺结核患者572例,成功治疗率为70.63%(404/572)。干预组成功治疗率为90.11%(246/273);内对照组成功治疗率为80.15%(218/272);外对照组成功治疗率为71.22%(433/608)。与内、外对照组比较,干预组的成功治疗率显著升高,差异均有统计学意义(χ2=10.688、38.055,均P<0.05)。干预组农村患者成功治疗率为89.22%(207/232);内对照组农村患者成功治疗率为78.97%(184/233);外对照组农村患者成功治疗率70.63%(404/572)。与内、外对照组比较,农村户籍干预组的成功治疗率显著升高,差异均有统计学意义(χ2=9.135、31.284,均P<0.05)。结论采取有针对性的,积极有效的结核病知识宣传和健康教育,可减少肺结核患者的延误诊断或治疗,提高患者的治疗依从性。
Objective To explore the application of independent mission and management in patients with active pulmonary tuberculosis and to provide a theoretical basis for the management of patients with pulmonary tuberculosis. Methods 545 cases of active pulmonary tuberculosis diagnosed and registered in Yulin TB Control Center in 2013 were enrolled in the study. The patients were divided into intervention group and control group according to the ratio of 1: 1. In 2013, Control center tuberculosis outpatient diagnosis and registration of 608 active patients classified as external control group. Count data using χ2 test, P <0.05 for the difference was statistically significant. Results A total of 545 active tuberculosis patients were enrolled and treated in Yulin City in 2013, with a success rate of 85.14% (464/545). 465 rural tuberculosis patients were enrolled for treatment. The successful treatment rate was 84.09% (391/465). 2013 In Beiliu City, 608 cases of active pulmonary tuberculosis were enrolled and treated. The successful treatment rate was 71.22% (433/608). 572 cases of rural tuberculosis registered and treated were successfully treated. The successful treatment rate was 70.63% (404/572). The successful treatment rate was 90.11% (246/273) in the intervention group, 80.15% (218/272) in the control group and 71.22% (433/608) in the external control group. Compared with the internal control group and external control group, the successful treatment rate in the intervention group was significantly increased, the difference was statistically significant (χ2 = 10.688,38.055, all P <0.05). The successful treatment rate of rural patients in intervention group was 89.22% (207/232). The successful treatment rate of rural patients in internal control group was 78.97% (184/233). The success rate of external treatment group was 70.63% (404/572) in rural patients. Compared with the internal control group and the external control group, the successful treatment rate of rural household registration group was significantly increased, the differences were statistically significant (χ2 = 9.135, 31.284, all P <0.05). Conclusions A targeted, active and effective knowledge of TB knowledge and health education can reduce the delay diagnosis or treatment of patients with pulmonary tuberculosis and improve the treatment compliance of patients.