1981～1998年中国麻风病例发现方式的研究  

Studies on Detection Modes of Leprosy in China During the Years 1981 Through 1998

作　　者：陈祥生[1] 李文忠[1] 江澄[1] 朱成斌[1] 叶干运[1] 

机构地区：[1]中国医学科学院,中国协和医科大学皮肤病研究所,全国性病麻风病控制中心,南京210042

出　　处：《中华皮肤科杂志》2000年第S1期14-17,共4页Chinese Journal of Dermatology

摘　　要：目的 分析麻风的发现方式及其影响因素与结果。方法 根据 1981～ 1998年间全国麻风患者登记资料，对其发现方式进行研究。结果 皮肤科就诊、接触者检查、线索调查和普查方式发现的病例比例与年代间存在显著性相关，表现为皮肤科就诊及接触者调查发现的患者比例明显上升，而线索调查及普查发现的患者比例则明显下降。在 1997～ 1998年间，通过皮肤科门诊和自报发现病例成为主要的病例发现方式，分别占发现病例总数的 37.3％和 28.6％，而接触者检查仅占 9.1％。多菌型患者的自报比例明显高于少菌型患者，少菌型患者通过皮肤科就诊发现的比例 (38.0％ )显著高于多菌型患者 (33.5％ )。在不同级别城市或农村，即省会城市、地市和县以下地区中，地市和县以下地区的自报和线索调查发现的患者比例明显高于省会城市。在卫生服务可及性较好的地区通过皮肤科门诊发现的比例 (75.9％ )明显高于可及性较差的地区，而在麻风流行地区，自报和线索调查是主要的病例发现方式。尽管通过不同方式发现，绝大多数患者仍然通过麻风专业机构确诊，仅 6.5％的患者是通过皮肤科医生发现并确诊。结论 本研究提示在鼓励皮肤科医生参与麻风防治的同时对其进行麻风知识培训的重要性。Objective To analyze the detection modes of leprosy and their influencing factors and outcomes. Methods Based upon the nationwide registration of leprosy patients detected during 1981～ 1998, the profiles of these patients at detection were studied. Results The proportions of cases significantly correlated with calendar years in the detection by dermatologic clinic, contact check, clue survey and mass survey, showing a significant increases in percentage of cases detected through dermatologic clinic and contact check and decreases through clue survey and mass survey. Detection of leprosy cases through dermatologic clinic and voluntary reporting became the main modes of case－ finding during 1997－ 1998, accounting for 37.3％ and 28.6％ respectively, whereas contact check only accounted for 9.1％ . More MB patients were detected by voluntary reporting than PB, whereas detection by dermatologic clinic resulted in a significantly higher proportion (38.0％ ) in PB patients than in MB (33.5％ ). The voluntary reporting and clue survey resulted in higher proportions of detection in prefecture and county rural areas. In areas with good facilities of dermatologic services, significantly higher extent (75.9％ ) of cases were detected through dermatologic clinic, whereas the voluntary reporting and clue survey were main modes of case detection in endemic areas. A great majority of cases were confirmed by leprosy units even though they were detected by various modes. Only 6.5％ of leprosy cases were detected and consequently confirmed by doctors in dermatologic clinics. Conclusion This study emphasizes the importance of providing training on leprosy to the doctors in dermatologic clinics while continuously encouraging their involvement in leprosy control.

关 键 词：麻风 发现方式 

分 类 号：R755.01[医药卫生—皮肤病学与性病学]