涂阳肺结核患者首诊延误和病人延误的比较  

Comparison Between First Diagnosis Delay and Patients'Delay among Patients with Smear-positive Pulmonary Tuberculosis

作　　者：钟荣[1] 段琼红 汪鹏[1] 吕静[1] 王齐[1] 叶临湘[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院统计学系,武汉430030 [2]武汉市结核病防治所,武汉430030

出　　处：《医学与社会》2010年第11期56-58,共3页Medicine and Society

摘　　要：目的:对武汉市结核病防治所涂阳肺结核患者的首诊延误和病人延误及影响因素进行比较分析。方法:采用自行设计问卷,对229例涂阳肺结核患者进行问卷调查,并采用二分类的logistic回归对首诊延误和病人延误进行多因素分析。结果:145例患者首诊延误等于病人延误,中位数为10天;79例患者病人延误远大于首诊延误,中位数分别为38天和7天。首诊延误危险因素为男性,初中及以下文化者,无咯血者及结核知识分低者;病人延误危险因素为初中及以下文化者,初治患者,结核知识分低者,自卑感严重者,及首诊于区以下医疗机构者。结论:涂阳肺结核患者存在一定的首诊和病人延误,应加强人群中结核知识的宣教,特别是文化程度低者;减少对结核病的歧视和孤立,消除患者自卑感;提高结防专业机构利用率,缩短首诊和病人延误,提高发现率以控制结核病。Objective：To study on the current situation and factors of the two treatment seeking delay among smear-positive pulmonary tuberculosis patients in TB hospital of Wuhan.Methods：229 patients with smear-positive pulmonary tuberculosis were investigated by using a self-designed questionnaire by personal interview.First diagnosis delay and patients＇delay during treatment seeking were analyzed,and multivariate analysis were done by two using Binary Logistics regression.Results：145 cases＇patients＇delay is equal to first diagnosis delay,with a median of 10 days;and 79 cases＇patients＇delay was much larger than first diagnosis delay,with a median of 38 days and 7 days respectively.The male,middle school or below education,no hemoptysis and lower TB-related knowledge were risk factors for the first diagnosis delay;Middle school or below education,untreated patients,lower TB-related knowledge,severe self-esteem and self-stigma were risk factors for patients＇delay.Conclusion：There is certain first diagnosis delay and patients＇delay.We should strengthen the TB-related knowledge among people,particularly those with low educational level;reduce discrimination and isolation of TB,eliminate patients＇self-shame;improve the utilization of TB prevention and control institutions,and reduce first diagnosis delay and patients＇delay,and improve detection rate of patients,thereby reducing the spread of tuberculosis and to better control TB.

关 键 词：涂阳 肺结核 首诊延误 病人延误 

分 类 号：R521[医药卫生—内科学]