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目的了解近3年焦作市医疗机构丙肝病例诊断能力及报告质量,对丙肝病例感染危险因素进行调查,为丙型肝炎的科学防治提供依据。方法选择2014—2016年焦作市辖区内丙肝病例报告数较多的综合医院及传染病医院,对其特定时间内报告的丙肝病例,与现行报告标准进行核对,采用抗-HCV和HCV-RNA阳性上报率、诊断分类符合率、分期正确率对焦作市2014—2016年丙肝病例报告质量进行评估。同时对住院病例的流行病学史进行回顾性调查,了解丙肝病例感染的危险因素。结果市级医院中具备核酸检测能力的医院占66.67%,县级医院中委托外单位开展核酸检测的医院占60%,区级医院既不开展也不委托外单位开展核酸检测;共核查388例住院病例,有流行病学史者269例,占69.33%;在有流行病学史患者中,共登记可能的危险因素461人次,其中手术史占34.06%、输血(血制品)/器官移植等占28.42%、美容纹身占10.20%;抗-HCV(+)网络上报率为76.12%,HCV-RNA(+)上报率为71.30%;丙肝病例诊断分类正确率为73.71%,临床分期正确率为58.76%。结论我市丙型肝炎病例的诊断能力和报告质量较低,需要加强培训和督导检查。
Objective To understand the diagnostic ability and quality of hepatitis C cases in medical institutions in Jiaozuo in recent 3 years and to investigate the risk factors of hepatitis C infection in order to provide scientific basis for the prevention and control of hepatitis C. Methods General hospitals and infectious disease hospitals with more cases of hepatitis C reported in Jiaozuo area from 2014 to 2016 were selected to check the reported cases of hepatitis C in their specific time with the current reporting standards and to adopt anti-HCV and HCV-RNA positive Reporting rate, diagnostic classification coincidence rate, staging correct rate of Jiaozuo 2014-2016 hepatitis C case report to assess the quality of. At the same time, the epidemiological history of inpatients was retrospectively investigated to understand the risk factors of HCV infection. Results The municipal-level hospitals had 66.67% of the hospitals with the ability to detect nucleic acids, 60% of the hospitals in the county-level hospitals that commissioned the testing of nucleic acids, and none of the district-level hospitals carried out or commissioned the units to carry out nucleic acid tests. A total of 388 cases Among the hospitalized cases, there were 269 cases with history of epidemiology, accounting for 69.33%. Among the patients with epidemiological history, 461 cases were registered as possible risk factors, including 34.06% of surgical history, blood transfusion (blood products) / organ transplantation Accounting for 28.42%, cosmetic tattoos accounted for 10.20%; anti-HCV (+) network reported rate of 76.12%, HCV-RNA (+) reported rate of 71.30%; hepatitis C case diagnostic classification accuracy rate was 73.71% 58.76%. Conclusion The diagnosis ability and report quality of Hepatitis C cases in our city are low, and we need to strengthen the training and supervision inspection.