结核病线索调查探讨  

Investigation report on Qinba sanitation supportive project of tuberculosis clue

作　　者：陈训[1] 邓成立[1] 

机构地区：[1]陕西省镇安县疾病预防控制中心,711500

出　　处：《临床肺科杂志》2005年第5期598-599,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探寻符合边远山区农村实际的结核病人最经济易行的发现办法。方法选择居住较为集中、交通略便利,人口约1.7万人的乡镇作为线索调查点。按3个月至14岁,15至59岁,60岁以上三个年龄段设计六类不同线索进行调查,对胸透异常和咳嗽、咯痰≥3周及既往有结核病史者进行X线摄片,对胸片异常者,同时送3份合格痰标本,直接涂片检查抗酸干菌。结果线调点活动性肺结核35例,涂阳病人12例,患病率为197.1/10万,涂阳患病率为67.6/10万。其线索调查肺结核病人发现率118.3/10万,涂阳病人发现率33.8/10万;2例复治多年耐多药难治病例,耐药率11.3/10万。结论通过三年秦巴卫生结核病控制项目的实施,活动性肺结核患病率和涂阳患病率较2000年明显下降。说明结核病控制项目成效显著。线索调查以咳嗽、咳痰≥3周者活动性,涂阳发现率高,分别为45.1/10万和16.9/10万;有结核病史者次之,检出率分别为16.91/10万和5.6/10万;15岁以下儿童和60岁以上老人PPD筛查和胸透普查均发现活动性和涂阳肺结核病人,发现率发别为16.9/10万和5.6/10万;咳嗽、咳痰<3周及其它症状发现1例活动性肺结核,发现率为5.6/10万;与活动性肺结核病人密切接触者未检出;耐多药结核病患者的治疗带来很大困难,并对结核病流行产生严重后果。Objective To seek the most economical and simple method for identifying TB clues in mountainous and rural areas.Methods One centralized residence area, a town with convenient transportation and its population around 170000, was chosen for the study. The whole population was divided into different age groups: 3 month to 14 years old, 15 to 59 years old, and 60 years or older for a design of 6 kinds. For those with the findings abnormal on CT, with and coughing, coughing with phlegm longer than 3 weeks and those with a phthisic history, X-ray examination was carried out. If abnomal, the patients were asked to bring 3 qualified phlegm samples to the hospital and a spread slice test was taken directly to check anti-acid bacillus.Results There were 35 active phthisic patients and 12 spread slice test masculine patients. The infected rate was 197.1/100000, spread slice test masculine rate was 67.6/100000, and the incidence was 33.8/100000. 2 cases of long term repeated treatment patients had been diagonosed as multiple-drug-residence and the rate was 11.3/100000.Conclusion Three years after carrying out Qinba sanitization TB control project, TB infection rate of spread slice test masculine has obviously decreased compare to 2000, which means the control project has achieved good results. The clue investigation found that those with coughing, and coughing with phlegm longer than 3 week has a higher activity and spread slice test masculine rate. No infection was found among those who have had close contact with active TB patients. Those with multiple-drug resistent have shown difficulty in the treatment and may have severe consequences.

关 键 词：结核病线索调查 结核病控制项目 活动性肺结核病人 涂阳肺结核病人 15岁以下儿童 60岁以上 涂阳患病率 病人发现率 2000年 密切接触者 结核病患者 山区农村 方法选择 X线摄片 涂片检查 涂阳病人 难治病例 严重后果 耐多药 

分 类 号：R52[医药卫生—内科学] R521.04[医药卫生—临床医学]