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目的对久治未愈菌阳肺结核病例进行社会经济学状况调查,为今后有效控制和减少久治未愈菌阳肺结核病的发生提供科学依据。方法选取2003-2004年上海市新登记疗程超过18个月仍未治愈的菌阳肺结核患者92例为病例组,按性别、年龄、初治、复治群体匹配同期上海市新登记完成治疗的菌阳肺结核患者85例为对照组,通过问卷调查的方法,对久治未愈菌阳肺结核病例社会经济学状况进行调查分析。结果初中以下文化程度、离异/丧偶、自费诊治、家庭负担重的病人更易造成久治未愈肺结核病例发生;由于该类病人病程长、病情复杂,造成诊疗费及个人费用支出较多,带来沉重的经济负担,因病致贫,因贫致病,形成恶性的疾病与经济循环链;肺结核知识知晓率对照组略高于病例组,职业分布中病例组学生的知晓率最高,对照组中干部的知晓率最高。结论对文化程度低、离异/丧偶、自费诊治、家庭负担重的病人要给予更多的关注,必须加大政府投入,特别是困难病人的生活补助和惠及耐药病人的二线抗结核药物的减免,提高政策保障力度;同时,进一步加强临床宣教和社区管理,减少耐药与不规律服药的发生,有效控制和减少久治未愈菌阳病例的形成。
Objective To investigate the socioeconomic status of tuberculosis patients who have not cured the disease for a long time and to provide a scientific basis for the effective control and reduction of the occurrence of tuberculosis of the lung in the past. Methods Ninety-two cases of bacillary positive pulmonary tuberculosis patients who were still newly cured in Shanghai during 2003-2004 were enrolled in this study. The cases were matched by gender, age, 85 cases of positive pulmonary tuberculosis patients as control group, through the method of questionnaire survey, the long-term treatment of non-cured cases of positive pulmonary tuberculosis cases of socio-economic investigation and analysis. Results Lower secondary education, divorced / widowed, self-pay diagnosis and treatment, the family burden of patients more likely to cause chronic treatment of unhealed tuberculosis cases; as long duration of such patients, the condition is complicated, resulting in more treatment costs and personal expenses, causing heavy Of the economic burden, due to illness caused by poverty, due to poverty and disease, the formation of a vicious disease and economic cycle chain; awareness of tuberculosis knowledge control group slightly higher than the case group, occupational distribution in the case group of students the highest awareness of the control group of cadres The highest awareness. Conclusions More attention should be paid to patients with low education level, divorced / widowed, self-financing diagnosis and treatment, and heavy family burden, which must be increased by government investment, especially for those patients with difficult living conditions and second-line anti-tuberculosis drugs benefiting patients with drug resistance At the same time, to further strengthen clinical education and community management, to reduce the incidence of drug-resistant and irregular medication, and to effectively control and reduce the formation of long-cured and non-cured bacillary positive cases.