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[目的 ] 为探索湘南铁路地区急性菌痢高发原因及防治对策。 [方法 ] 收集 1994～ 1998年医院病例资料 ,并作 1999年现状调查 ,运用危害分析和关键控制点 (HACCP)和规范管理 (GMP)方法实施防治对策 ,作效果观察。 [结果 ] 误诊病例多 ,铁路流动人口多 ,菌痢传入机会频率高 ,环境卫生质量差 ,是报告发病率高的原因 ,运用HACCP和 GMP方法后 ,误诊率由原来的 42 %下降到 8% ,发病率 (6 8.34/10万 )比前五年年均 2 12 .5 /10下降了6 7.8%。 [结论 ] 诊断欠规范、误诊病例多 ,是报告发病率的关键因素 ;其次为铁路客运从业人员接触传染机会多、流动人员多 ,运用 HACCP和 GMP管理方法能够有效地控制急性菌痢的高发病率。
[Objective] To explore the causes of acute bacillary dysentery in southern Hunan railway and the prevention and cure measures. [Methods] The data of hospital cases from 1994 to 1998 were collected, and the status quo was surveyed in 1999. The prevention and cure measures were implemented with the method of hazard analysis and critical control point (HACCP) and standard management (GMP), and the effect was observed. [Results] There were many cases of misdiagnosis, more floating population in railway, high frequency of introduction of bacillary dysentery and poor quality of sanitation, which were the reasons for the high incidence of reported cases. After using HACCP and GMP methods, the misdiagnosis rate dropped from 42% to 8 %, And the incidence rate (6 8.34 / 100,000) decreased by 6 7.8% over the average of 2 12 .5 / 10 in the previous five years. [Conclusions] The number of misdiagnosis cases and misdiagnosis cases are the key factors to report the morbidity. The second is that the railway passenger transport workers have more chances of contact and infection and more floating workers. The use of HACCP and GMP management methods can effectively control the high incidence of acute bacillary dysentery rate.