上海市南汇区农村肺结核病人诊疗管理模式比较研究  

Comparison of the two management patterns of tuberculosis diagnosis and treatment in rural area of Nanhui District,Shanghai

作　　者：黄星[1] 梅建[1] 肖绍坦 李世宏[1] 鲍叔达 陈金妹[1] 张枭[1] 浦忠兰 朱静怡[1] 

机构地区：[1]上海市南汇区疾病预防控制中心,201300

出　　处：《应用预防医学》2009年第6期321-324,共4页Applied Preventive Medicine

基　　金：上海市卫生局百人培养计划课题

摘　　要：目的探索一种以乡村医生为主体的农村结核病社区管理方法,建立一套可行的、便于在农村推广应用的、切实有效的管理模式,提高结核病防治管理水平,减少肺结核病对民众健康造成的危害。方法采用社区试验研究方法,将以乡村医生为主体的管理模式设为实验组,以社区卫生服务中心结防医生为主体的管理模式设为对照组,实验组、对照组各随机选取5个社区,分析比较两组肺结核病人的诊疗管理情况。结果实验组研究对象的及时就诊情况、标准化治疗方案使用情况、治疗的第二个月末查痰情况、治疗转归情况、医生随访情况以及结核病防治宣传情况均优于对照组,其中实验组的标准化治疗方案使用情况、医生随访情况、治疗转归情况和结核病防治宣传情况,经统计学检验与对照组存在显著差别(P<0.05)。结论在农村地区开展以乡村医生为主体的农村结核病管理模式在病人的诊疗管理方面优势显著,推广以乡村医生为主体的结核病管理模式对提高农村地区结核病防治管理水平,减少结核病的危害具有重要意义。Objective To explore a new approach to community management of tuberculosis with the village doctors as the main body in order to establish a feasible and effective management pattern of tuberculosis. Methods A community trial was conducted to compare the two management patters of tuberculosis diagnosis and treatment . Ten communities were randomly divided into two groups, one group was selected as experimental group and another was selected as control group. As the main body, the village doctors specially trained by Nanhui District Center for Disease Prevention and Control were arranged in the experimental group while the doctors taking charge of tuberculosis prevention and treatment from community health Center were in control group. Results The conditions including the time from the onset to treatment, the use of standardized treatment protocols, sputum examination at the end of second month, medical follow - up, clinical outcome and health education propaganda in experimental group were better than those in the control group, statistically significant difference was found in the conditions of the use of standardized treatment protocols, medical follow - up, clinical outcome and health education propa ganda. Conclusion Using the traind village doctors as the main body, the community management pattern of tuberculosis in rural area is of significant advantage compared with the doctors taking charge of tuberculosis diagnosis and treatment from the community health center and it is of great importance and significance to promote the use of trained village doctors as the main body for community management of tuberculosis.

关 键 词：肺结核病 诊疗情况 社区试验 管理模式 

分 类 号：R521.01[医药卫生—内科学]