重庆市医疗机构对肺结核患者发现的贡献作用

发布时间：2018-01-29 23:50

  本文关键词： 结核 肺 预防和控制 医疗机构 病人转诊　出处：《重庆医学》2017年34期 　论文类型：期刊论文

【摘要】：目的通过分析重庆市医疗机构网络报告肺结核疫情及转诊和到位确诊患者情况,评价医疗机构在提高患者发现中的贡献作用。方法通过重庆市各县区的结核病控制工作月报表和结核病管理信息系统获得重庆市2006-2015年医疗机构网络直报的肺结核疫情数和确诊的肺结核患者数,采用χ2检验对不同年份、不同类别医疗机构的报告水平和确诊患者进行分析。结果 2006-2015年全市医疗机构累计网络直报实际肺结核疫情323 603例,报告数逐年上升。转诊到位率低于全国平均水平,且近年来呈下降趋势。通过医疗机构网络报告总体到位率逐年提高,活动性肺结核患者贡献率由2006年的10.14%上升至2015年的52.09%(χ2=25 610.75,P0.01),涂片阳性肺结核患者贡献率由2006的6.42%上升至2015年的52.46%(χ2=10 520.65,P0.01),耐多药肺结核患者贡献率为44.9%。市级综合医院、县区级综合医院等发现的患者逐年增加(P0.01)。医疗机构来源的患者发现延误中位数为56d,延误率为79.62%。结论医疗机构对肺结核患者的发现贡献逐渐增大,但该部分患者的发现延误情况严重。
[Abstract]:Objective to report the tuberculosis epidemic situation, referral and definite diagnosis by analyzing the network of medical institutions in Chongqing. Methods Medical institutions in Chongqing from 2006 to 2015 were obtained through the tuberculosis control work month report and tuberculosis management information system in various counties and districts of Chongqing. The number of tuberculosis cases reported directly on the network and the number of confirmed tuberculosis patients. 蠂 2 test was used for different years. Results from 2006 to 2015, 323,603 cases of tuberculosis were reported directly by the cumulative network of medical institutions in the whole city. The number of reports increased year by year, the referral rate was lower than the national average level, and in recent years there was a downward trend. The overall arrival rate reported through the network of medical institutions increased year by year. The contribution rate of active pulmonary tuberculosis patients increased from 10.14% in 2006 to 52.09 in 2015 (蠂 2 25 610.75 P 0.01). The contribution rate of smear positive pulmonary tuberculosis patients increased from 6.42% in 2006 to 52.46 in 2015 (蠂 2 + 10 520.65% P 0.01). The contribution rate of MDR-TB patients was 44.9%. The number of patients found in county and district general hospitals increased year by year (P 0.01). The median delay of patients from medical institutions was 56 days. The delay rate is 79.62.ConclusionThe contribution of medical institutions to the discovery of pulmonary tuberculosis is gradually increasing, but the delay of discovery in this part of patients is serious.
【作者单位】： 重庆市结核病防治所防治科;
【基金】：重庆市卫生计生委医学科研计划项目(2015MSXM106)
【分类号】：R521
【正文快照】： 结核病防治机构是我国肺结核防治工作的主要负责机构,也是肺结核患者发现、登记和治疗管理的专业性实施单位。然而很大一部分患者出现肺结核可疑症状以后,首次就诊未选择结核病防治机构[1]。鉴于此种情况,2004、2005年原卫生部办公厅分别下发了《关于进一步加强肺结核病疫情报，

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