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[目的]总结经验教训,为非牧区布鲁氏菌病(布病)防治提供依据。[方法]对2003~2008年布病非牧区章丘市发生的36例布病患者资料与医疗机构相关资料进行调查。[结果]36例患者中,50~75岁的占58.33%;患者对布病传染源、传播途径、临床表现、个人防护知识,的知晓率分别为27.78%、38.89%、8.33%、25.00%。患者就诊次数最多的是村卫生所(中位数4.12次),发病至初诊时间最长的是市级医院(中位数56 d),初诊至确诊时间最长的是村卫生所(中位数123 d),发病至确诊时间最长的是村卫生所(中位数151 d);初次就诊或随后的复诊时被误诊的28例,误诊率为77.78%。村卫生所、乡镇卫生院、市级医院的误诊率分别为88.89%、77.78%、53.57%。[结论]章丘市布病病例误诊率较高,确诊时间延误,主要原因是医务人员缺乏布病防治知识。
[Objective] To summarize the experiences and lessons and provide basis for the prevention and treatment of brucellosis (brucellosis) in non-pastoral areas. [Method] The data of 36 patients with brucellosis and the related data of medical institutions were investigated in Zhangqiu City, which was the non-pastoral area from 2003 to 2008. [Results] Among 36 patients, 58.33% were from 50 to 75 years old. The awareness rates of infection sources, route of transmission, clinical manifestation and personal protective knowledge were 27.78%, 38.89%, 8.33% and 25.00% . The number of visits was the highest among village clinics (median 4.12). The longest period of hospitalization was municipal hospitals (median 56 days), and the longest confirmed period was the village clinics (median (123 d). The longest time of diagnosis was the village clinics (median 151 days). The misdiagnosis rate was 77.78% in the first visit or subsequent referral. The misdiagnosis rates of village clinics, township hospitals and municipal hospitals were 88.89%, 77.78% and 53.57% respectively. [Conclusion] The misdiagnosis rate of brucellosis cases in Zhangqiu City is high, and the time of confirming the diagnosis is delayed. The main reason is the lack of knowledge of brucellosis prevention and control in medical personnel.