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目的:了解目前重庆市区县级综合医疗机构开展结核病防治工作现况,分析存在的主要问题,为今后医防合作的开展提供依据。方法:对抽查的县乡级综合医疗机构结核病防治工作情况进行现场评估,调查综合医疗机构的实验室诊断能力、X光胸片诊断能力、结核病疫情报告、转诊、住院结核病患者规范化治疗情况,根据评估所得数据进行分析评价。结果:部分县乡级综合医疗机构开展了结核病痰涂片检查,涂片阳性率分别为9.8%、9.4%;县乡级综合医疗机构胸部X线摄片质量合格率分别为100.0%、89.1%,诊断复核符合率分别为98.3%、88.5%,差异均有统计学意义;县乡级综合医疗机构结核病疫情报告率分别为88.3%、91.0%,网络报告日期与放射科登记日期之间间隔天数中位数均为0,转诊到位率分别为42.6%、47.4%;区县级综合医院住院患者使用标准化抗结核化疗方案率为63.0%,初治患者使用二线药物率为32.4%。结论:重庆市县乡级综合医疗机构基本能完成各项结核病防治工作任务,但在各项技术策略方面还有待进一步规范。
Objective: To understand the status quo of tuberculosis prevention and treatment work carried out by county-level general medical institutions in Chongqing at present and to analyze the main problems that exist so as to provide the basis for future cooperation in medical prevention. Methods: On-the-spot assessment of tuberculosis prevention and control work of the county-level comprehensive medical institutions was conducted to investigate the laboratory diagnosis ability, diagnostic ability of X-ray, diagnostic report of tuberculosis, referral and standardized treatment of tuberculosis in general hospitals, According to the evaluation of the data for analysis and evaluation. Results: Some county and township level general medical institutions conducted sputum smear tests, the smear positive rates were 9.8% and 9.4% respectively. The passing rate of chest radiography at county and township level general medical institutions was 100.0% and 89.1% , And the diagnostic coincidence rates were 98.3% and 88.5%, respectively. The differences were statistically significant. The report rates of tuberculosis outbreaks in county-level general medical institutions were 88.3% and 91.0% respectively, and the number of days between the date of network report and registration date of radiology was Median were 0, referral rate were 42.6%, 47.4%; district-level general hospital inpatients using standardized anti-TB regimen was 63.0%, first-line treatment of patients with second-line drugs was 32.4%. Conclusion: The county and township level general medical institutions in Chongqing can basically complete the task of tuberculosis prevention and control. However, they still need to be further regulated in various technical strategies.