福建省泉州市3个乙型病毒性肝炎监测试点县病例诊断报告质量调查  

Diagnosis and reporting of hepatitis B in 3 surveillance counties in Quanzhou,Fujian

作　　者：陈雅红[1,2] 陈冰[1] 石神鉴 洪思让[1] 杨虹雨 郑金凤[2,4] 

机构地区：[1]泉州市疾病预防控制中心,福建泉州362000 [2]福建医科大学公共卫生学院教学基地,福建福州350001 [3]福建医科大学公共卫生学院,福建福州350001 [4]福建省疾病预防控制中心,福建福州350001

出　　处：《疾病监测》2014年第12期999-1002,共4页Disease Surveillance

基　　金：国家科技重大专项(No.2012ZX10002001-002-002)~~

摘　　要：目的分析福建省泉州市南安市、晋江市及安溪县3个县(市)2011、2013年乙型病毒性肝炎(乙肝)监测工作前后乙肝病例诊断以及报告质量情况,为更好地规范乙肝诊断和报告,了解急性乙肝发病情况,为乙肝防控提供参考依据。方法采用分层系统随机抽样方法,抽取南安市、晋江市和安溪县9家医疗机构2011年以及2013年乙肝报告病例,通过查阅病历和实验室检测结果对照乙肝诊断标准进行报告诊断核实调查。并在每个医院选取一定数量的临床医生,通过问卷和访谈调查,了解其对乙肝病例诊断、报告相关知识的认知情况。结果 2011年乙肝病例诊断报告准确率为93.4%(255/273),误报率6.6%(18/273)。2013年诊断报告准确率为96.7%(265/274),误报率为3.3%(9/274)。2011年乙肝分类诊断准确率为78.1%,2013年为91.8%。调查64名临床医生,14.1%的医生认为乙肝病例要反复上报;3.1%的医生认为乙肝病毒携带者也需要上报;3个县(市)2013年乙肝报告发病率为67.5/10万,较2011年下降了5.9%,其中急性乙肝下降了82.9%,未分类病例减少85.8%。结论 3个试点县(市)开展乙肝监测工作后乙肝诊断报告及分类诊断正确率有明显提高,急性乙肝报告发病率明显下降。乙肝报告诊断仍有重报、错报、诊断不清现象,需继续加强对医疗机构的培训和督导。Objective To compare the quality of diagnosis and reporting of hepatitis B in Nanan, Jinjiang and Anxi counties in Quanzhou, Fujian province before （2011 ） and after （2013） hepatitis B surveillance program implementation. Methods Reported hepatitis B cases seeking medical care in 9 medical institutions in the 3 counties in 2011 and 2013 were selected by stratified random sampling to evaluate the related diagnosis and reporting according to the medical records and laboratory detection results. Questionnaire survey was conducted among the doctors in the 9 medical institutions to understand their awareness of hepatitis B diagnosis and reporting. Results The accurate rates of hepatitis B reporting were 93.4% （255/273） and 96. 7% （265/274）, respectively, in 2011 and 2013 ,the mis-reporting rates were 6. 6% （18/273） and 3. 3% （9/274）, respectively and the consistency rates in hepatitis B diagnosis classification were 78. 1% and 91.8%, respectively. Among 64 doctors surveyed, 14. 1% said that hepatitis B cases should be reported repeatedly, and 3. 1% believed that hepatitis B virus carrier should be reported too. In 2013 ,the reported incidence of hepatitis B was 67. 5/lakh, a decline of 5.9% compared with 2011. The incidences of acute hepatitis B and unclassified cases declined by 82. 9% and 85. 8%. Conclusion The accuracy of hepatitis B reporting was improved obviously and incidence of acute hepatitis B declined significantly in the 3 counties. Because there were re-reporting, ntis-reporting and misdiagnosis, it＇s necessary to strengthen the training and supervision on hepatic B diagnosis and reporting.

关 键 词：乙型病毒性肝炎 诊断质量 调查 

分 类 号：R512.62[医药卫生—内科学]