耐多药肺结核患者既往诊治情况调查研究  

Previous treatment and management history of patients with multidrug-resistant tuberculosis(MDR-TB)

作　　者：张加胜[1] 孙强[1] 李文婧[1] 边学峰[1,2] 闫赟[1] 王黎霞[3] 李仁忠[3] 

机构地区：[1]山东大学卫生管理与政策研究中心,济南250012 [2]济南市疾病预防控制中心,济南250001 [3]中国疾病预防控制中心结核病预防控制中心,北京102206

出　　处：《中国防痨杂志》2011年第8期471-474,共4页Chinese Journal of Antituberculosis

基　　金："十一五"国家重大科技专项(2008ZX10003-007)

摘　　要：目的了解耐多药患者从确诊为肺结核病到确诊为耐多药肺结核病之间的治疗行为,以及在此期间所获得的管理服务情况。方法采用结构式访谈问卷调查在天津市、黑龙江省大庆市、河南省濮阳市3个项目市专科医院住过院的43位耐多药肺结核患者。运用SPSS 16.0软件对获取的资料进行统计分析。结果 53.5%(23/43)的患者首次抗结核治疗是在结核病防治机构(简称结防机构),37.2%(16/43)的患者首次抗结核没有完成治疗疗程。从确诊为肺结核病到确诊为耐多药肺结核病期间,患者平均治疗天数为767 d,平均费用为24 536元,72.1%(31/43)的患者在2家以上的医疗机构治疗过,23.3%(10/43)的患者存在停药行为,46.5%(20/43)的患者有结核病防治人员访视。结论研究对象的治疗过程复杂、治疗行为不规范,结防机构的管理也不到位。应当加强对患者的引导和管理,提高患者的治疗依从性,防止耐药的产生。Objective To investigate the previous treatment and management history of patients with MDR-TB. Methods Questionnaires were used to investigate 43 hospitalized multidrug-resistant tuberculosis patients in TB hospitals in Tianjin,Daqing and Puyang in order to get the quantitative data and SPSS 16.0 was used for data analysis. Results 53.5%（23/43） of patients received the first treatment in TB dispensaries,37.2%（16/43）of patients did not complete the first anti-TB treatment.The treatment days between diagnosis of TB and MDR-TB are 767 days on average.The average cost is 24 536 yuan,72.1%（31/43） of patients had been treated in more than two medical institutions,23.3%（10/43） of patients had ever interrupted the treatment,46.5%（20/43）of patients was managed under the doctors＇ supervision. Conclusion The treatment process was complex and treatment behavior was not standardized.The management of TB dispensary is inadequate.Therefore,we should strengthen the guidance and management to patients in order to improve the treatment compliance and avoid the occurrence of MDR-TB.

关 键 词：结核 肺/药物疗法 抗药性 多种 细菌 病人依从 

分 类 号：R521[医药卫生—内科学]