青海省新发涂阳肺结核病人治疗转归分析
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摘要
目的分析2011-2017年第一季度新发涂阳肺结核病人治疗转归情况,找出工作过程中存在的问题并提出改进意见,为今后开展执行结核病防治工作提供借鉴。方法对2011-2017年第一季度各级结核病诊疗单位在"全国结核病管理信息系统"上报且已经审核通过的病人流行病学数据进行收集,并做描述性流行病学统计分析。结果治愈率为90. 04%,不同年份治愈率差异有统计学意义(χ_(趋势)~2=105. 76,P <0. 01),有下降趋势;海西州病人治愈率最高,为93. 58%,果洛州最低,为76. 31%,不同地区治愈率差异有统计学意义(χ~2=269. 07,P <0. 01);汉族病人治愈率最高,为92. 26%,藏族最低,为85. 96%,不同民族病人治愈率差异有统计学意义(χ~2=87. 38,P <0. 01);工人治愈率最高,为96. 48%,牧民治愈率最低,为83. 84%,不同职业病人治愈率差异有统计学意义(χ~2=126. 19,P <0. 01);不同年龄组新发涂阳肺结核病人治愈率差异无统计学意义(χ_(趋势)~2=9. 93,P=0. 002);因症就诊的病人治愈率最高,为93. 52%,其他来源(健康检查、密切接触者筛查等)的病人治愈率最低,为66. 67%,不同来源病人治愈率差异有统计学意义(χ~2=62. 58,P <0. 01);非重症病人和重症病人治愈率差异有统计学意义(χ~2=90. 04,P <0. 01);随着发现延误期限的延长,治愈率有下降趋势(χ_(趋势)~2=49. 51,P <0. 01)。结论青海省新发涂阳肺结核发现数逐年减少、治愈率有下降趋势;牧区、非汉族、牧民、老年及青少年病人,和来源为其他、重症病人以及发现延误的病人需要更多关注。
Objective To analyze the treatment outcomes of new smear positive pulmonary tuberculosis( TB) cases in the first quarter of 2011-2017 in Qinghai Province,so as to identify problem( s) in the work process and put forward suggestions for improvement,and provide reference for future implementation of tuberculosis prevention and treatment. Methods For the first quarter of 2011-2017,the epidemiological data was collected and analyzed which was reported and approved in National Information System of Tuberculosis Management by TB institutions in Qinghai Province. Descriptive epidemiological methods were used. Results The cure rate was 90. 04%,the difference in cure rate in different years was statistically significant( χ_(tend)~2=105. 76,P < 0. 01),and there was a downward trend. The cure rate of Haixi patients was the highest,which was 93. 58%,and the lowest in Guoluo,76. 31%. The cute rate of different prefectures was statistically significant( χ~2= 269. 07,P < 0. 01).The cure rate of Han patients was the highest,92. 26%,and the lowest among Tibetans,85. 96%. The difference in cure rate between different ethnic groups was statistically significant( χ~2= 87. 38,P < 0. 01). The cure rate of workers was the highest,96. 48%,and the cure rate of herders was the lowest,83. 84%. The difference in cure rate between different occupational patients was statistically significant( χ~2= 126. 19,P < 0. 01). There was no significant difference in the cure rate between new smear-positive pulmonary tuberculosis patients in different age groups( χ_(trend)~2= 9. 93,P = 0. 002); the highest cure rate for patients with symptomatic treatment was 93. 52%,other sources( health check,close contact sieve) the patient's cure rate was the lowest,66. 67%. The difference in cure rate between different sources was statistically significant( χ~2= 62. 58,P < 0. 01). The difference in cure rate between non-severe patients and critically ill patients was statistically significant( χ~2= 90. 04,P < 0. 01);with the prolongation of the delay period,the cure rate has a downward trend( χ_(trend)~2= 49. 51,P < 0. 01). Conclusion The number of new discovered smear-positive tuberculosis in Qinghai Province has decreased year by year and the cure rate has decreased.Pastoral areas,non-Han,pastoralists,elderly and adolescent patients,and patients from other sources,critically ill patients and those found to be delayed need more attention.
Objective To analyze the treatment outcomes of new smear positive pulmonary tuberculosis( TB) cases in the first quarter of 2011-2017 in Qinghai Province,so as to identify problem( s) in the work process and put forward suggestions for improvement,and provide reference for future implementation of tuberculosis prevention and treatment. Methods For the first quarter of 2011-2017,the epidemiological data was collected and analyzed which was reported and approved in National Information System of Tuberculosis Management by TB institutions in Qinghai Province. Descriptive epidemiological methods were used. Results The cure rate was 90. 04%,the difference in cure rate in different years was statistically significant( χ_(tend)~2=105. 76,P < 0. 01),and there was a downward trend. The cure rate of Haixi patients was the highest,which was 93. 58%,and the lowest in Guoluo,76. 31%. The cute rate of different prefectures was statistically significant( χ~2= 269. 07,P < 0. 01).The cure rate of Han patients was the highest,92. 26%,and the lowest among Tibetans,85. 96%. The difference in cure rate between different ethnic groups was statistically significant( χ~2= 87. 38,P < 0. 01). The cure rate of workers was the highest,96. 48%,and the cure rate of herders was the lowest,83. 84%. The difference in cure rate between different occupational patients was statistically significant( χ~2= 126. 19,P < 0. 01). There was no significant difference in the cure rate between new smear-positive pulmonary tuberculosis patients in different age groups( χ_(trend)~2= 9. 93,P = 0. 002); the highest cure rate for patients with symptomatic treatment was 93. 52%,other sources( health check,close contact sieve) the patient's cure rate was the lowest,66. 67%. The difference in cure rate between different sources was statistically significant( χ~2= 62. 58,P < 0. 01). The difference in cure rate between non-severe patients and critically ill patients was statistically significant( χ~2= 90. 04,P < 0. 01);with the prolongation of the delay period,the cure rate has a downward trend( χ_(trend)~2= 49. 51,P < 0. 01). Conclusion The number of new discovered smear-positive tuberculosis in Qinghai Province has decreased year by year and the cure rate has decreased.Pastoral areas,non-Han,pastoralists,elderly and adolescent patients,and patients from other sources,critically ill patients and those found to be delayed need more attention.
引文
[1] WHO. Global tuberculosis report 2016[R]. Geneva:WHO,2016.
[2]中华人民共和国国务院办公厅.全国结核病防治规划(2011-2015年)[Z]. 2017-02-01.
[3]王宇,王文杰,刘霞,等.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,2011:44.
[4]王陇德.结核病防治[M].北京:中国协和医科大学出版社,2004:133.
[5]卫生部疾病预防控制局,卫生部医政司,中国疾病预防控制中心.中国结核病防治规划实施工作指南(2008版)[M].北京:中国协和医科大学出版社,2009:20.
[6]伍子健,曾燃元,申良田,等.邵阳市新涂阳肺结核病人发现延迟分析[J].实用预防医学,2008,15(2):448-449.
[7]谢惠安,阳国太,林善梓.现代结核病学[M].北京:人民卫生出版社,2000:696-700.
[8]崔国强. 2000-2009年怀柔区涂阳肺结核病人转归队列分析[J].中国防痨杂志,2011,33(3):184-185.
[9]龙令杏. 233例痰菌阳性肺结核疫情特征与化疗效果分析[J].现代预防医学,2012,39(10),2556-2558.
[10]朱艳丽,李秀红.健康教育在初治肺结核病人中的需求及应用[J].中国医药导报,2010,7(2):154-155.
[11]顾芳慧,刘民,姜世闻,等.北京市两区糖尿病合并肺结核人群流行病学特征分析[J].中国预防医学杂志,2013,14(4):246-250.
[12]戈启萍,孔忠顺,朴建玲,等. 95例住院高龄肺结核临床分析[J].中国防痨杂志,2000,22(4):188-192.
[13]温宇,周流凤.北海市实施DOTS项目后涂阳肺结核病人治疗失败影响因素分析[J].临床肺科杂志,2010,15(10):1452-1453.
[14] LAWN SD,AFFUL B,ACHEAMPONG JW. Acheampong. Pulmonary tuberculosis:diagnostic delay in Ghanaian adults[J]. INT J Tuberc Lung Dis,1998,2(8):635-640.
[15]杜建,徐彩红,杨应周,等.标准短程化疗方案治疗初治复治肺结核失败原因分析[J].中国病原生物学杂志,2012,7(7):523-526.
[16]王撷秀.积极发现、治愈肺结核病人[J].中国防痨杂志,2001,23(4):213.
[2]中华人民共和国国务院办公厅.全国结核病防治规划(2011-2015年)[Z]. 2017-02-01.
[3]王宇,王文杰,刘霞,等.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,2011:44.
[4]王陇德.结核病防治[M].北京:中国协和医科大学出版社,2004:133.
[5]卫生部疾病预防控制局,卫生部医政司,中国疾病预防控制中心.中国结核病防治规划实施工作指南(2008版)[M].北京:中国协和医科大学出版社,2009:20.
[6]伍子健,曾燃元,申良田,等.邵阳市新涂阳肺结核病人发现延迟分析[J].实用预防医学,2008,15(2):448-449.
[7]谢惠安,阳国太,林善梓.现代结核病学[M].北京:人民卫生出版社,2000:696-700.
[8]崔国强. 2000-2009年怀柔区涂阳肺结核病人转归队列分析[J].中国防痨杂志,2011,33(3):184-185.
[9]龙令杏. 233例痰菌阳性肺结核疫情特征与化疗效果分析[J].现代预防医学,2012,39(10),2556-2558.
[10]朱艳丽,李秀红.健康教育在初治肺结核病人中的需求及应用[J].中国医药导报,2010,7(2):154-155.
[11]顾芳慧,刘民,姜世闻,等.北京市两区糖尿病合并肺结核人群流行病学特征分析[J].中国预防医学杂志,2013,14(4):246-250.
[12]戈启萍,孔忠顺,朴建玲,等. 95例住院高龄肺结核临床分析[J].中国防痨杂志,2000,22(4):188-192.
[13]温宇,周流凤.北海市实施DOTS项目后涂阳肺结核病人治疗失败影响因素分析[J].临床肺科杂志,2010,15(10):1452-1453.
[14] LAWN SD,AFFUL B,ACHEAMPONG JW. Acheampong. Pulmonary tuberculosis:diagnostic delay in Ghanaian adults[J]. INT J Tuberc Lung Dis,1998,2(8):635-640.
[15]杜建,徐彩红,杨应周,等.标准短程化疗方案治疗初治复治肺结核失败原因分析[J].中国病原生物学杂志,2012,7(7):523-526.
[16]王撷秀.积极发现、治愈肺结核病人[J].中国防痨杂志,2001,23(4):213.