北京市西城区332例新涂阳肺结核患者治愈影响因素分析  

Influencing factors of cure for 332 new smear-positive pulmonary tuberculosis patients in Xicheng District of Beijing

作　　者：李慧颖[1] 

机构地区：[1]北京市西城区疾病预防控制中心,北京100031

出　　处：《中国热带医学》2018年第2期135-138,共4页China Tropical Medicine

摘　　要：目的探讨新发涂阳肺结核患者的治愈情况及影响因素,以提高治愈率。方法利用肺结核患者登记本、管理卡片、病历资料以及结核病管理信息系统对2009—2015年北京市西城区结核病防治所门诊登记管理的332例新涂阳肺结核患者基本特征及治疗情况进行分类统计。从中选取7个可能影响新涂阳肺结核患者治愈的指标,应用SPSS 17.0软件进行χ~2检验及Logistic回归分析,提供相应的P值和OR值,从而最终确定影响因素。结果 332例患者纳入本研究。其中本市户籍患者202例,占60.8%,外地户籍患者130例,占39.2%,男女比例为1.7∶1,职业分布以家务及待业为主。治愈305例,治愈率为91.9%。单因素分析结果显示户籍、患者来源、治疗前痰菌检测结果、合并糖尿病、肺部空洞及诊断延误差异有统计学意义(P<0.05),将以上变量作为自变量引入Logistic回归方程进行多因素分析,最终结果显示户籍、合并糖尿病、诊断延误,是影响新涂阳肺结核患者治愈的主要因素,其中户籍的OR值为3.819,明显高于其他影响因素的OR值,是影响新涂阳肺结核患者治愈率的最主要因素。结论加强结核病健康教育,完善医疗保障制度,建立有效的跨区域管理运行机制,提高专科医院及综合医院医务人员诊疗能力,注重合并症的治疗等是提高新涂阳肺结核患者治愈率的关键。Objective To investigate the cure condition of new smear-positive pulmonary tuberculosis patients anddiscuss the influencing factors, so as to improve the cure rate. Methods The registration books, management cards, medicalrecords and tuberculosis management information system of pulmonary tuberculosis patients were used to collect the relativedata and the data of 332 cases of new smear-positive pulmonary tuberculosis patients were analyzed for their basiccharacteristics and treatments in Xicheng District Tuberculosis Control Institute of Beijing from 2009 to 2015. Seven indicatorswhich might influence the cure condition of the new smear-positive pulmonary tuberculosis patients were selected andanalyzed with the chi-square test and logistic regression analysis by SPSS17.0 software, The corresponding P value and the OR value are provided to determine the influencing factors finally. Results Totally 332 patients were included in this study, andamong them, 202 patients had the city residence（60.8%） and 130 were migrant（39.2%）. The male to female ratio was 1.7∶1,and the main occupations of them were household work and unemployment. Totally 305 patients were cured with a cure rate of91.9%. The single factor analyses showed that the differences in census register, patient origin, pre-treatment sputum testresults, diabetes, lung cavity and diagnosis delay were statistically significant（P〈0.05）.and multiple factor analyses wascarried out to introduce the above variables as independent variables into Logistic regression equation, and the final result wasshowed that the census register, diabetes, and diagnosis delay were the influencing factors of the cure rate. The census registerwas the main influencing factor（OR=3.819）. Conclusion To strengthen the health education about tuberculosis, reform themedical security system, set up the effective cross regional management operation mechanism, improve the medical personneldiagnosis and treatment ability in specialist hospitals and general hospitals, and pay

关 键 词：肺结核 治愈 影响因素 

分 类 号：R52[医药卫生—内科学]