贵州省山区涂阳肺结核患者治疗依从性现况及影响因素分析  

Analysis of treatment compliance and its impact factors of smear-positive pulmonary tuberculosis patients in mountainous area of Guizhou

作　　者：陈玮[1] 杨早[1] 雷世光[1] 李杨[1] 潘建敏[1] 黄文辉[2] 杨敬源[3] 宋群锋[1] 许金红[1] 

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004 [2]江西省疾病预防控制中心 [3]贵阳医学院

出　　处：《现代预防医学》2012年第15期3948-3950,共3页Modern Preventive Medicine

基　　金：贵州省疾病预防控制中心科研基金(2008-2-5)

摘　　要：目的了解贵州山区涂阳肺结核患者抗结核治疗依从性及相关影响因素。方法按照随机抽样方法,从贵州省9个山区县抽取405名涂阳肺结核病患者,并进行问卷调查。结果 405名调查对象的平均年龄为(44.42±17.67)岁;男性278人,占68.6%,女性127人,占31.4%;治疗过程中出现漏服药的有113人,占27.9%;在漏服药组中,有52%患者是由于抗结核药物的毒副作用而停止服药或漏服药,有29%是因为工作忙或遗忘,因外出务工、交通不便或其他原因而漏服药的占19%;漏服药组与未漏服药组在医生访视次数方面差异具有统计学意义(P﹤0.05);治疗一段时间后,如果症状消失,在未漏服药组中,有10.3%的患者认为可以停止服药,在漏服药组中,有28.9%的患者认为可以停止服药,两组差异具有统计学意义(P﹤0.05)。结论抗结核药的副反应是导致山区涂阳患者依从性较低的主要原因,医生访视频次较低以及健康教育不到位可能影响患者服药意识,结防机构应采取相应措施减少药物毒副反应,并加强对患者的健康教育以及增加医生督导访视频次等。OBJECTIVE To know the treatment compliance and its correlative impact factors of the smear-positive pulmonary tuberculosis （TB） patients in mountainous area of Guizhou. METHODS A random sampling method was adopted, 405 smear- positive pulmonary TB patients were selected from 9 mountainous counties of Guizhou and carried through questionnaire survey. RESULTS The average age of 405 patients was 44.42 ＋ 17.67 years old; there were 278 men and 127 women, accounted for 68.6% and 31.4% respectively; in the course of treating, the patients of neglecting to dose were 113, accounted for 27.9%, a- mong these patients, the proportion of adverse drug response resulted in with drawling was 52%, busy working or forgetting to dose was 29%, working outside, discommodious traffic and else causes were 19%; there was a statistical meaning on the dif- ference of doctor visiting times between neglecting to dose patients group and no neglecting to dose patients group （P 〈 0.05） ; after a period of treating, if symptom disappeared, 10.3% and 28.9% of patients thought that stopping dosing was tolerable re- spectively in neglecting to dose patients group and no negleeting to dose patients group, there was a statistical meaning on the difference （P 〈 0.05）. CONCLUSION Adverse drug response is the main factor resulting in the low compliance of the smear- positive pulmonary TB patients in mountainous area, lesser doctor visiting times and insufficient health education can impact the patients＇ dosing consciousness. Adopting to relevant measures to decrease adverse drug response, strengthening health education for the patients and increasing doctor visiting times have important significance to improve the patients＇ treating compliance.

关 键 词：结核 依从性 山区 贵州省 

分 类 号：R521[医药卫生—内科学]