推行结核病防治服务新体系前后肺结核病诊疗规范性分析  

Analysis of normative diagnosis and treatment on tuberculosis before and after implementation of new service system

作　　者：王昌浩 李静[2] 

机构地区：[1]甘肃省天水市疾病预防控制中心,甘肃天水741000 [2]甘肃省天水市第一人民医院,甘肃天水741000

出　　处：《疾病预防控制通报》2018年第1期40-42,共3页Bulletin of Disease Control & Prevention(China)

摘　　要：目的了解甘肃省天水市推进结核病防治服务新体系前后肺结核病诊疗的规范性,分析新体系运行前后诊疗水平的变化。方法随机抽取全市推进结核病防治服务新体系建设工作前(2012—2013年)后(2015—2016年)完成疗程的肺结核病病例各400例,由天水市结核病诊疗质量控制专家组对诊断和治疗的规范性进行评价。结果推行新体系前诊断规范率93.00%、治疗规范率96.00%,推行新体系后诊断规范率97.00%、治疗规范率94.00%,转型前后诊断规范率差异有统计学意义(χ~2=6.737,P=0.009),但是治疗规范率的差异无统计学意义(χ~2=1.684,P=0.194);推行新体系前诊断规范率涂阳病人98.55%、涂阴病人91.84%,推行新体系后涂阳病人100.00%、涂阴病人96.24%,转型前后涂阳诊断规范率的差异无统计学意义(χ~2=1.182,P=0.227),但是涂阴诊断规范率的差异有统计学意义(χ~2=5.564,P=0.018)。结论天水市推行结核病防治服务新体系建设工作后,肺结核病的诊断水平,尤其是涂阴肺结核病的诊断水平得到了提高。Objective To understand the normalization of tuberculosis（TB） diagnosis and treatment, and analyze the changes of diagnosis and treatment level before and after the implementation of new service system of TB prevention and treatment in Tianshui, Gansu province. Methods There were 400 TB cases randomly selected before the implementation of new service system of TB prevention and treatment during 2012—2013 and other 400 TB cases selected after that from 2015 to 2016. All cases finished the treatment process and the normalization of TB diagnosis and treatment was estimated by the experts on quality control. Results Before and after the implementation of the new service system, the rate of normative diagnosis was respectively 93.00% and 97.00% with statistical difference（χ~2=6.737, P=0.009）; the rate of normative treatment was respectively 96.00% and 94.00% without statistical difference（χ~2=1.684, P=0.194）; the rate of normative diagnosis based on smear positive was respectively 98.55% and 100.00% without statistical difference（χ~2=1.182, P=0.227）; the rate of normative diagnosis based on smear negative was respectively 91.84% and 96.24% with statistical difference（χ~2=5.564, P=0.018）. Conclusions The diagnostic ability of pulmonary tuberculosis, especially the diagnosis of smear negative tuberculosis, is improved after the implementation of new service system of TB prevention and treatment in Tianshui.

关 键 词：结核病 防治体系 诊疗规范 

分 类 号：R52[医药卫生—内科学] R183[医药卫生—临床医学]