云南省重点地区460例伤寒、副伤寒病例诊断准确性调查结果分析

发布时间：2018-05-20 19:41

本文选题：伤寒副伤寒 + 诊断准确性　；参考：《现代预防医学》2017年17期

【摘要】：目的了解云南省重点地区伤寒、副伤寒病例诊断的准确性及符合率,为判明当地疫情是否真正高发提供理论依据。方法依照国家诊断标准对重点地区2013-2015年报告的伤寒、副伤寒病例开展回顾性调查。分析比较不同病种、不同地区和不同级别医疗机构诊断符合率及不符合情况。结果 460例调查病例中,伤寒病例占62.8%,副伤寒病例占37.2%。有135例病例完全符合诊断,总诊断符合率为29.35%,其中副伤寒诊断符合率高于伤寒(X~2=86.18,P0.001);不同地区和不同级别医疗机构诊断符合率均存在差异(X~231.48,P0.001),地区以红河州最高(62.22%),医病机构以州市级最高(45.52%)。有325例(70.65%)诊断不规范,其中169例(52%)应排除诊断,156例(48%)应订正为伤寒、伤寒其它诊断类型。不符合诊断类型主要是伤寒和副伤寒确诊病例。结论云南省伤寒、副伤寒病例诊断准确性低,报告疫情数据不真实。按国家标准诊断、报告病例和重点开展病原菌分离、培养方法,有助于提高病例诊断的准确性及符合率。
[Abstract]:Objective to understand the accuracy and coincidence rate of diagnosis of typhoid fever and paratyphoid fever in key areas of Yunnan Province, and to provide theoretical basis for determining whether the local epidemic situation is really high. Methods according to the national diagnostic criteria, the cases of typhoid and paratyphoid in key areas from 2013 to 2015 were investigated retrospectively. The diagnostic coincidence rate and nonconformities of different diseases, different regions and different levels of medical institutions were analyzed and compared. Results among 460 cases investigated, 62.8 cases were typhoid and 37.2% paratyphoid. 135 cases were in full conformity with the diagnosis. The diagnostic coincidence rate of paratyphoid fever was higher than that of Typhoid fever X2X (86.18U) P0.001N, and the diagnostic coincidence rate of X231.48U P0.001 was different in different regions and different grades of medical institutions. The highest rate of diagnosis in Honghe Prefecture was 62.22%, and the highest in medical institutions was 45.52%. Other diagnostic types of typhoid fever and typhoid fever should be revised. The main types of nonconforming diagnosis were confirmed cases of typhoid and paratyphoid fever. Conclusion the diagnostic accuracy of typhoid fever and paratyphoid fever in Yunnan Province is low, and the reported data are not true. It is helpful to improve the accuracy and coincidence rate of diagnosis according to the national standard, to report the cases and to carry out the isolation and cultivation of pathogenic bacteria.
【作者单位】：云南省疾病预防控制中心;昆明市西山区疾病预防控制中心;
【分类号】：R181.3;R516.3

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