2008-2014年安徽省非结防机构肺结核患者转诊与追踪情况分析  

Analysis on referral and tracing of tuberculosis cases reported from network by non-TB control institutions in Anhui Province during 2008-2014

作　　者：汤莉[1,2] 邹铮[2] 王纪祥[2] 方雪晖[2] 张根友[2] 陶芳标[1] 

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,安徽合肥230032 [2]安徽省胸科医院(安徽省结核病防治研究所),安徽合肥230022

出　　处：《中华疾病控制杂志》2016年第3期299-302,共4页Chinese Journal of Disease Control & Prevention

摘　　要：目的分析安徽省2008-2014年非结防机构肺结核患者网络报告、转诊与追踪情况,探索提高结核病患者发现水平的措施,为加强结核病防治工作提供科学依据。方法收集、整理安徽省2008-2014年结核病网络直报数据及同期报表,患者相关登记本,进行统计分析。结果 2008-2014年非结防机构报告结核病患者和疑似患者250 226例,总体到位227 694例,总体到位率为91.00%,到位病例中确诊为活动性肺结核患者102 154例,其中初治涂阳48 315例,占活动性肺结核患者的47.30%,复治涂阳3 017例,占2.96%,涂阴患者47 823例,占46.81%。与2008年比较,2014年患者转诊率提高了50.74%(X^2=20 915.98,P<0.001),转诊到位率总体呈下降趋势,追踪率提高了31.49%(X^2=7 323.37,P<0.001),追踪到位率提高了31.56%(X^2=5 206.08,P<0.001),总体到位率提高了24.85%(X^2=7 230.69,P<0.001)。追踪未到位原因中以外出所占比例最高,占23.23%,其次为拒绝就诊,占16.31%,查无此人占9.76%,死亡占7.78%,另有42.92%的患者原因不明。结论非结核病防治机构在肺结核防治中起着重要作用,加强医防合作,完善肺结核患者转诊、追踪制度,将有助于进一步提高病人发现水平。Objective To analyze the status of referral and tracing of tuberculosis （TB） cases reported via internet by non-TB control institutions in AnHui province from 2008 to 2014, and to explore measures for improving tuberculosis ca- ses finding and provide scientific basis for TB prevention and control program. Methods Data report forms and records of patient TB registration from 2008-2014 were collected and analyzed. Results 250 226 patients with suspected tuberculosis were reported by the non-TB control institutions in AnHui province from 2008 to 2014, the total arrival rate was 91%, 102 154 cases were diagnosed with active tuberculosis, among whom 48 315 were initial smear-positive cases, accounting for 47. 30% of the patients with active tuberculosis, 3 017 were retreatment smear-positive tuberculosis cases, accounting for 2.96% , 47 823 were smear-negative patient cases, accounting for 46. 81%. Compared with 2008, patients with referral rate increased by 50. 74% （ 2 =20 915.98,P〈0.001）, tracking rate increased by 31.49% （χ^2 =7 323.37,P 〈 0.001 ） , referral arrival rate increased by 31.56% （ χ^2= 5 206.08, P 〈 0. 001 ） , the total arrival rate increased by 24. 85% （χ^2 = 7 230. 69,P 〈 0. 001 ） in 2014. Among the referral from China TB Direct Report System, the TB cases which could not be traced, the highest proportion of patients went out, accounting for 23.23%, 16. 31% cases refused treatment, 9. 76% cases were not found, deaths accounted for 7.78% , 42. 92% cases were not followed-up for unknown reasons. Conclusions Non-TB control institutions play an important role in TB prevention and control program. TB case detection by enhancing the collaboration with non-TB control institutions and improving TB suspect referring and tracing sys- tem will further improve the ability of identifying patients.

关 键 词：结核 肺 病人转诊 流行病学方法 

分 类 号：R521[医药卫生—内科学] R181.22[医药卫生—临床医学]