广州市海珠区肺结核患者就诊延误影响因素的研究  

Factors associated with patients' delayed diagnosis of pulmonary tuberculosis in Haizhu District of Guangzhou City

作　　者：伍小英[1] 钟小燕[2] 谭守勇[3] 张晋昕[2] 黄嘉玲[2] 宋嘉麒 杜雨华[1] 张雅惠[1] 罗少霞[1] 

机构地区：[1]广州市胸科医院广州市结核病防治所结核科,广东广州510000 [2]中山大学公共卫生学院医学统计与流行病学系,广东广州510080 [3]广州市胸科医院结核科,广东广州510095

出　　处：《中华疾病控制杂志》2016年第6期564-567,共4页Chinese Journal of Disease Control & Prevention

基　　金：广州市科技计划项目(2014Y2-00104);广州市医药卫生科技一般引导项目(20131A011075);广州市胸科医院科研基金项目(XK2013-011)

摘　　要：目的 分析广州市海珠区肺结核患者就诊延误情况及其影响因素,为制定减少就诊延误发生的干预措施提供科学依据。方法 采取随机抽样调查方法,应用编制的问卷对2014年1月1日~2014年12月31日登记发现的150例广州市海珠区肺结核患者进行面对面的问卷调查,并收集患者病历资料,分别从基本情况、经济因素及临床因素分析就诊延误的影响因素。结果 150例肺结核患者就诊延误率为52.0%（78/150）。多因素分析结果表明转诊（OR=0.121,95%CI：0.028~0.513）、咯血（OR=0.291,95%CI：0.098~0.860）是减少就诊延误的因素;就诊交通费支出≥50元/月（OR=7.334,95%CI：1.729~31.113）、因症就诊（OR=3.225,95%CI：1.337~7.775）是增加就诊延误的因素。结论 广州市海珠区肺结核患者存在一定的就诊延误,提高人群结核病相关知识的知晓水平,加强转诊,改善结核病定点医疗机构服务的可及性和便利性,增强人群健康体检意识,从而减少肺结核患者就诊延误。Objective To analyze the factors associated with patients＇ delayed diagnosis of pulmonary tuberculosis in Haizhu District of Guangzhou City and provide scientific intervention measures to avoid the delay. Methods The ran- dom sampling method was adopted. There were 150 cases diagnosed with pulmonary tuberculosis from January 1st, 2014 to December 31 st, 2014. They were investigated by face-to-face questionnaire, and the basic medical information was collect- ed. Influential factors of delayed diagnosis of pulmonary tuberculosis were explored from common information, economic sit- uation and clinical status. Results The patients＇ delay rate in 150 cases of pulmonary tuberculosis was 52. 0% （78/ 150）. Multi-factor analysis showed that the referral （ OR =0. 121,95% CI： O. 028-0. 513） and hemoptysis （ OR =0. 291, 95% CI： 0. 098-0. 860） were beneficial factors for the delay. The transportation expenses over 50 Chinese Yuan per month （OR =7. 334, 95% CI： 1. 729-31. 113） and the symptom-driven （OR =3. 225, 95% CI： 1. 337-7. 775） were risk factors leading to the delay. Conclusions Patients＇ delay diagnosis is popular in pulmonary tuberculosis patients in Haizhu Dis- trict of Guangzhou, and we should spread public knowledge on pulmonary tuberculosis to reduce the occurrence and improve the convenience and accessibility of certificated tuberculosis medical institution, it is important to strengthen public con- sciousness of regular physical examination.

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] R181.2[医药卫生—临床医学]