河北省保定市实施“三位一体”后涂阳肺结核病人减少原因分析  

Analysis on the causes of decline in smear positive pulmonary tuberculosis patients after the new trinity TB control network in Hebei Baoding

作　　者：李京华[1] 张雁[1] 张永强[1] 张进国 赵凤芹[1] 张今文[3] 郝云涛[4] LI Jinghua, ZHANG Yan, ZHANG Yongqiang, ZHANG Jinguo, ZHAO Fengqin, ZHANG Jinwen, HAO Yuntao(Baoding City Center for Disease Control and Prevention, Hebei 071000, Chin)

机构地区：[1]保定市疾病预防控制中心,河北071000 [2]易县疾病预防控制中心 [3]北京中医药大学东方学院 [4]承德医学院附属医院

出　　处：《医学动物防制》2018年第4期395-398,共4页Journal of Medical Pest Control

基　　金：2017年保定市科学技术研究与发展计划(第二批)项目(17ZF310)

摘　　要：目的分析保定市结核病防治试行"三位一体"过程中涂阳肺结核病人变化情况,并提出改进意见。方法从"全国结核病管理信息系统"中导出其转型前一年内和转型后一年内登记的肺结核病人数据,对其进行统计学处理,并结合现场调查情况进行分析。结果保定市19所门诊转型前一年内涂阳肺结核病人登记率为16.87/10万(1 390/8240 464),转型后为9.95/10万(840/8 442 796),转型后低于转型前,差异有统计学意义(χ2=149.36,P<0.05);转型前一年内涂阳肺结核病人占活动性肺结核病人比例为38.94%(1 390/3 570),转型后为25.83%(840/3 252),转型后低于转型前,差异有统计学意义(χ2=132.84,P<0.05)。结论转型初期结核病门诊不规范、痰菌检出率低,以及转诊制度不健全等问题的存在是涂阳肺结核病人数量减少的主要原因,结核病防治服务体系有待进一步规范。Objective To analyze the changes of smear positive pulmonary tuberculosis patients in the new trinity TB control network in Baoding City,and put forward some suggestions for improvement. Methods From＂The national TB management information system＂,the data of pulmonary tuberculosis patients in the year before and after the transformation were derived and analyzed statistically. Results 19 clinics in Baoding,the registration rate of smear positive pulmonary tuberculosis patients was16. 87/100 000（ 1 390/8 240 464） in the previous year,and 9. 95/100 000（ 840/8 442 796） after the transition. The registration rate of smear positive pulmonary tuberculosis patients before and after the transition,after the transition is lower than before the transition,the difference was statistically significant（ χ2= 149. 36,P〈0. 05）; the Proportion of smear positive pulmonary tuberculosis patients with active pulmonary tuberculosis was 38. 94%（ 1 390/3 570） and 25. 83%（ 840/3 252） after the transition. Comparison of the proportion before and after transformation,the transition was lower than before the transition,the difference was statistically significant（ χ2= 132. 84,P〈0. 05）. Conclusion The initial transformation of TB clinics were not standardized,the detection rate of sputum was low,and the referral system was not perfect,there were major causes of the number of smear positive tuberculosis patients decreased,tuberculosis prevention and control service system needs to be further standardized.

关 键 词：结核病防治 “三位一体” 涂阳肺结核 登记率 

分 类 号：R521[医药卫生—内科学]