2014—2017年陕西汉中市肺结核患者就诊延迟及影响因素
|
摘要
目的了解陕西省汉中市肺结核患者就诊延迟状况,分析延迟影响因素,为制定干预措施提供依据。方法选择汉中市2014—2017年度登记的肺结核患者7 648例,描述性别、年龄、民族、职业、户籍、治疗分类、患者来源、痰菌检查不同分类下的就诊延迟情况,采用非参数检验比较不同分类下的延迟天数及延迟天数构成,采用χ2检验比较不同分类下的延迟比例,采用Logistic回归进行就诊延迟的影响因素分析。结果 68. 63%的患者出现就诊延迟,所有结核病患者延迟就诊的中位天数为26d。不同年龄、户籍、职业、患者来源、痰菌检查结果的患者就诊延迟比例差异有统计学意义,其中40岁以上、流动人口、农民、因症就诊以及涂片阳性的患者延迟就诊比例更高。结论汉中市肺结核患者就诊延迟严重,应采取综合性干预措施改善就诊延迟情况,减少结核菌的传播。
Objective To understand the current status of health seeking delay of pulmonary tuberculosis(PTB) patients in Hanzhong City,Shaanxi Province,and analyze the associated factors of delay in order to provide the evidence for addressing the interventional strategies. Methods 7 648 PTB patients registered in Hanzhong City from 2014 to 2017 were selected and their information on health seeking delay were analyzed according to their classifications of sex,age,nationality,occupation,household registration,treatment category,patient source,and sputum examination result. Non-parametric test was used to compare delay days and the contribution of delay days under different classifications. χ2 test was used to compare the proportion of health seeking delay under different classifications,while logistic regression was used to analyze the associated factors of health seeking delays. Results68. 63% of PTB patients had health seeking delay,the median of delay for all PTB patients was 26 days. There was a statistically significant difference in the proportion of patients with health seeking delay depending on different age,family registration,occupation,patient source,and sputum examination results. The higher proportion of health seeking delay were observed among patients over the age of 40,migrants,farmers,patients with symptoms,and smear positive PTB patients. Conclusion The health seeking delay among PTB patients in Hanzhong City was serious,and comprehensive interventions should be considered to control the health seeking delay and reduce the spread of tuberculosis.
Objective To understand the current status of health seeking delay of pulmonary tuberculosis(PTB) patients in Hanzhong City,Shaanxi Province,and analyze the associated factors of delay in order to provide the evidence for addressing the interventional strategies. Methods 7 648 PTB patients registered in Hanzhong City from 2014 to 2017 were selected and their information on health seeking delay were analyzed according to their classifications of sex,age,nationality,occupation,household registration,treatment category,patient source,and sputum examination result. Non-parametric test was used to compare delay days and the contribution of delay days under different classifications. χ2 test was used to compare the proportion of health seeking delay under different classifications,while logistic regression was used to analyze the associated factors of health seeking delays. Results68. 63% of PTB patients had health seeking delay,the median of delay for all PTB patients was 26 days. There was a statistically significant difference in the proportion of patients with health seeking delay depending on different age,family registration,occupation,patient source,and sputum examination results. The higher proportion of health seeking delay were observed among patients over the age of 40,migrants,farmers,patients with symptoms,and smear positive PTB patients. Conclusion The health seeking delay among PTB patients in Hanzhong City was serious,and comprehensive interventions should be considered to control the health seeking delay and reduce the spread of tuberculosis.
引文
[1]WHO. Global tuberculosis report 2017[Z]. World Health Organization:Geneva,2017.
[2]卫生部疾病预防控制局.全国第五次结核病流行病学抽样调查资料汇编[M].北京:军事医学科学出版社,2011:33-47.
[3]白丽琼,肖水源.湖南省农村传染性肺结核患者发现延误的影响因素研究[J].中华结核和呼吸杂志,2004,27(9):617-620.
[4]肺结核诊断标准WS288-2008[S〗.中华人民共和国卫生部
[5]编委会.全国结核病防治工作手册(修订本)[M].北京:中国卫生出版社,2000.
[6]柴玲霞,孙钧,陆小梅.定西市农村地区肺结核患者就诊延迟原因分析[J].中国防痨杂志,2008,30(6):553-554.
[7]吴祖达,潘洁茹.福州地区肺结核患者就诊延迟及影响因素分析[J].海峡预防医学杂志,2016,22(1):12-107.
[8]赵燕,张天华.陕西省2015年肺结核患者就诊延迟及其相关因素分析[J].中国热带医学,2017,17(3):289-292.
[9]唐南,许琳.云南省2005年与2013年涂阳肺结核患者就诊延迟变化分析[J].公共卫生与预防医学,2015,26(2):20-23.
[10]蒋玲,王黎霞,等.重庆市梁平县肺结核患者就诊延迟及其相关因素分析[J].中国防痨杂志,2014,35(5):341-345.
[11]王荣,李晨.南京市2011-2013年肺结核患者就诊延迟状况及影响因素分析[J].中华疾病控制杂志,2015,19(8):854-856.
[12]曾伟,凤翀.巢湖市新发现涂阳肺结核病人就诊延迟相关因素调查分析[J].中华疾病控制杂志,2011,15(4):306-308.
[13]彭再生,蹇曾山.恩施自治州2007年肺结核发病情况调查分析[J].公共卫生与预防医学,2008,19(6):69-71.
[14]杨志红,程琮.老年与青年肺结核患者就诊延迟影响因素的对比分析[J].泰山医学院学报,2012,33(4):244-246.
[15]李进升,张晓丽.山区初治肺结核患者主动就诊延迟的影响因素分析[J].齐齐哈尔医学院学报,2014,35(16):2376-2378.
[16]高晓凤,贾显奉.西部2个贫困县肺结核患者发现延误情况及其影响因素分析[J].第三军医大学学报,2012,34(14):1471-1473.
[17]席海峰,李俊娟.城市流动人口初治活动性结核病患者就诊延迟情况分析[J].现代中西医结合杂志,2011,20(6):683-683.
[18]李永文,耿红.山东户籍及流动人口肺结核患者就诊延迟现状及影响因素[J].中国公共卫生,2014,30(4):392-395.
[19]陈兰妹.新发肺结核病诊断延迟分析[J].江西医学院学报,2005,45(2):79-80.
[20]娄泉伟,陈洁颖.肺结核患者就诊与确诊延迟因素研究[J].浙江预防医学,2015,27(9):889-892.
[2]卫生部疾病预防控制局.全国第五次结核病流行病学抽样调查资料汇编[M].北京:军事医学科学出版社,2011:33-47.
[3]白丽琼,肖水源.湖南省农村传染性肺结核患者发现延误的影响因素研究[J].中华结核和呼吸杂志,2004,27(9):617-620.
[4]肺结核诊断标准WS288-2008[S〗.中华人民共和国卫生部
[5]编委会.全国结核病防治工作手册(修订本)[M].北京:中国卫生出版社,2000.
[6]柴玲霞,孙钧,陆小梅.定西市农村地区肺结核患者就诊延迟原因分析[J].中国防痨杂志,2008,30(6):553-554.
[7]吴祖达,潘洁茹.福州地区肺结核患者就诊延迟及影响因素分析[J].海峡预防医学杂志,2016,22(1):12-107.
[8]赵燕,张天华.陕西省2015年肺结核患者就诊延迟及其相关因素分析[J].中国热带医学,2017,17(3):289-292.
[9]唐南,许琳.云南省2005年与2013年涂阳肺结核患者就诊延迟变化分析[J].公共卫生与预防医学,2015,26(2):20-23.
[10]蒋玲,王黎霞,等.重庆市梁平县肺结核患者就诊延迟及其相关因素分析[J].中国防痨杂志,2014,35(5):341-345.
[11]王荣,李晨.南京市2011-2013年肺结核患者就诊延迟状况及影响因素分析[J].中华疾病控制杂志,2015,19(8):854-856.
[12]曾伟,凤翀.巢湖市新发现涂阳肺结核病人就诊延迟相关因素调查分析[J].中华疾病控制杂志,2011,15(4):306-308.
[13]彭再生,蹇曾山.恩施自治州2007年肺结核发病情况调查分析[J].公共卫生与预防医学,2008,19(6):69-71.
[14]杨志红,程琮.老年与青年肺结核患者就诊延迟影响因素的对比分析[J].泰山医学院学报,2012,33(4):244-246.
[15]李进升,张晓丽.山区初治肺结核患者主动就诊延迟的影响因素分析[J].齐齐哈尔医学院学报,2014,35(16):2376-2378.
[16]高晓凤,贾显奉.西部2个贫困县肺结核患者发现延误情况及其影响因素分析[J].第三军医大学学报,2012,34(14):1471-1473.
[17]席海峰,李俊娟.城市流动人口初治活动性结核病患者就诊延迟情况分析[J].现代中西医结合杂志,2011,20(6):683-683.
[18]李永文,耿红.山东户籍及流动人口肺结核患者就诊延迟现状及影响因素[J].中国公共卫生,2014,30(4):392-395.
[19]陈兰妹.新发肺结核病诊断延迟分析[J].江西医学院学报,2005,45(2):79-80.
[20]娄泉伟,陈洁颖.肺结核患者就诊与确诊延迟因素研究[J].浙江预防医学,2015,27(9):889-892.