农村老年肺结核病例发现延误的影响因素研究  

Factors in Diagnostic Delay for Old Patients with Pulmonary Tuberculosis in Rural Areas

作　　者：潘琴琴[1] 杨俊超[1] 赵银莲[1] 吕鑫[1] 

机构地区：[1]湖州市吴兴区疾病预防控制中心,浙江湖州313000

出　　处：《浙江预防医学》2011年第6期20-23,共4页Zhejiang Journal of Preventive Medicine

基　　金：湖州市2010年度科技计划项目(2010YS07)

摘　　要：目的了解农村老年肺结核病例发现延误状况,探讨发现延误的影响因素。方法采取横断面调查方法,运用自制的调查表,对2007—2009年到湖州市结核病定点医院接受诊治的农村老年新发涂阳肺结核患者进行面对面调查。结果 237例痰涂片阳性的肺结核患者,从症状出现到被确诊为肺结核的发现延迟时间中位数为49 d（0-1164 d）;有157例（66.24%）患者存在发现延误。发现延误的影响因素有：居住地距离最近医疗卫生机构的距离、就诊前是否接受过结防宣教、首发症状咯血、首诊胸片检查、首诊未做任何检查、确诊前就诊医疗机构的次数和是否服用民间偏方行为。结论农村地区老年结核病普遍存在发现延误的现象,发现延迟时间较长。需采取综合性干预措施,减少农村老年结核病患者的发现延误。Objective To understand the causes of diagnostic delay for the old patients with pulmonary tuberculosis in rural areas.Methods Cross-sectional survey method was used in this study.A face to face interview was conducted in the new cases of pulmonary tuberculosis patients with a self-made questionnaire.Those patients were over 60 years old（≥60） and lived in rural areas for at least one year,received treatment in Huzhou tuberculosis hospital during 2007 to 2009.Results 237 smear positive cases were collected in this study.From the appearance of the symptom to the diagnosis of pulmonary tuberculosis,the median of time was 49 days（0-1164 days）.Among them,157 cases（66.24%） were diagnostic delay.The impact factors for diagnostic delay were distance between residence and the nearest health care institution,TB education before seeing a doctor,first hemoptysis symptoms,first treatment with a chest X-ray,first treatment without any check,the visiting number of the medical institutions before diagnosis,and the prior visiting folk herbalists.Conclusion Diagnostic delay for the elderly with pulmonary tuberculosis is common in rural areas.Comprehensive measures should be taken to reduce the diagnostic delay and enhance the TB control strategy training for medical staffs in different medical institutions.

关 键 词：肺结核 发现延误 影响因素 

分 类 号：R521[医药卫生—内科学]