2013～2015年乌鲁木齐市耐多药结核病就诊延迟现况与影响因素分析

发布时间：2018-08-24 10:07

【摘要】：目的通过对2013~2015年乌鲁木齐市耐多药结核病患者病案信息的分析,了解该市耐多药结核病就诊延迟现状及影响因素,为降低耐多药结核病就诊延迟率提供理论依据。方法收集2013年1月1日-2015年12月31日乌鲁木齐市耐多药结核病患者病案信息,并分析该类患者就诊延迟现状及影响因素。影响因素分析采用χ2检验、秩和检验及Fisher确切概率法。结果就诊延迟中位延迟时间为31 d,(P25-P75)为(28.00~83.75)d;最大延迟时间为378 d,最小延迟时间为4 d。3年期间耐多药结核病患者就诊延迟比例无趋势性变化(χ2=1.311,P=0.252)。治疗结局以治愈比重最大,其次为失访及死亡。影响因素除HIV检查结果差异有统计学意义外(Z=3.082,P=0.002),性别、年龄、民族、职业、人口类型、患者来源等11种因素差异均无统计学意义(P0.05);HIV检查结果呈阳性的患者耐多药结核病就诊延迟率较HIV检查结果阴性的患者低;就诊延迟患者完成治疗情况较未就诊延迟者差(P=0.035)。结论该市目前耐多药结核病存在就诊延迟现象,且就诊延迟率较高(66.667%);今后应加大管理力度,变被动监测为主动监测;同时加大对普通人群(至少是耐多药结核病易感人群)的结核病筛查力度,以便早期发现耐多药结核病患者,降低该市耐多药结核病就诊延迟率,严防耐多药结核病就诊延迟现象的反弹。
[Abstract]:Objective to analyze the medical records of MDR-TB patients in Urumqi from 2013 to 2015 and to find out the status quo of MDR-TB delay and its influencing factors so as to provide a theoretical basis for reducing MDR-TB delay rate. Methods the medical records of MDR-TB patients in Urumqi from January 1, 2013 to December 31, 2015 were collected, and the status quo of delay and influencing factors were analyzed. The influencing factors were analyzed by 蠂 2 test, rank sum test and Fisher exact probability method. Results the median delay time was 31 days, (P25-P75) was (28.00) 83.75 days, the maximum delay time was 378d, and the minimum delay time was 4 days. There was no trend change in the delay ratio of patients with MDR-TB (蠂 ~ 2 = 1.311P ~ (0.252). The proportion of cure was the largest, followed by missing visit and death. Except for the difference of HIV results, sex, age, nationality, occupation, population type, sex, age, nationality, occupation, population type, sex, age, nationality, occupation, population type, sex, age, nationality, occupation, population type, sex, age, nationality, occupation, population type, and so on. There were no significant differences in 11 factors such as source of patients (P0.05). The delay rate of multi-drug resistant tuberculosis patients with positive results was lower than that of patients with negative results of HIV examination, and the completion of treatment in patients with delayed visit was worse than that without delay (P0.035). Conclusion there is a phenomenon of delayed visit in MDR-TB in the city at present, and the delay rate is higher (66.667%), the management should be strengthened in the future, and the passive surveillance should be changed into active surveillance. At the same time, we should step up the screening of tuberculosis among the general population (at least the susceptible population of MDR-TB) in order to detect MDR-TB patients early and reduce the delay rate of MDR-TB visits in the city. Severe prevention of MDR TB treatment delay phenomenon rebound.
【作者单位】：新疆医科大学公共卫学院流行病与卫生统计学教研室;新疆乌鲁木齐市疾病预防控制中心结核病防治科;
【基金】：新疆维吾尔自治区自然科学基金(No:201442137-20) 乌鲁木齐市卫生局科学技术计划项目(No:201313)
【分类号】：R52

【参考文献】