珠海市无性病诊疗资质医疗机构梅毒血清学阳性者的转介服务研究  

Referral services to syphilis screening positive cases provided by the hospitals without STDs diagnosis and treatment qualification

作　　者：黄弦 李少平 韦宁 黄家驹 HUANG Xian;LI Shaoping;WEI Ning;HUANG Jiaju(Zhuhai Center for Chronic Disease Control, Zhuhai, Guangdong 519000, China)

机构地区：[1]珠海市慢性病防治中心

出　　处：《中国艾滋病性病》2018年第6期593-596,共4页Chinese Journal of Aids & STD

基　　金：广东省梅毒综合防治示范区项目;国家梅毒规范化诊疗试点项目~~

摘　　要：目的分析珠海市无性病诊疗资质的医疗机构,发现梅毒筛查阳性者后提供梅毒转介服务的情况,为合理制定梅毒诊疗策略提供依据。方法查阅珠海市2015年2月至2017年4月无性病诊疗资质医疗机构的实验室记录,获取梅毒筛查阳性者的信息;通过上报的转介单,分析转介情况、转介人群特征和未转介原因;通过追踪转介人群到位情况,分析转介到位的影响因素和未到位的原因;通过收治医院门诊病历系统,收集到位者的诊断与治疗情况。结果 24家梅毒筛查机构共发现筛查阳性者364例,其中女性为主,占70.33%（256例）,妇产科占57.69%（210例）;共转介309例,转介率84.89%,转介病人以女性为主,占73.79%（228/309）,孕产妇为主要人群。＂医生忘转介＂是未转介的主要原因;转介到位共180例,转介到位率58.25%（180/309）。影响转介到位的因素中有统计学差异的有：性别、人群和转出机构性质。＂追踪失联＂和＂自行在非定点医疗机构诊疗＂是未到位的主要原因。转介到位人群中的梅毒确诊率为83.33%（150/180）,梅毒患者的规范治疗率为92.67%（139/150）。结论梅毒筛查阳性者存在较高确诊率。转介服务意义重大,转介服务可让患者获得较高的规范治疗率,但到位率低是存在的主要问题。应加强民营医院和综合医院的转介服务培训,对目标人群提供更有针对性的转介服务。Objective To analyze the referral services of the cases with syphilis positive results screened in the hospitals without STDs diagnosis and treatment qualification in Zhuhai so as to provide reference for the policy making.Methods The information of the syphilis screened positive were collected from the testing records of the hospitals during Feb.2015 to Apr.2017.The characteristics and impact factors of those referred and not referred to STDs hospitals were analyzed.The diagnosis and treatment of those referred successfully were also collected by the outpatient medical record system.Results A total of 364 cases with syphilis positive symptoms were selected from24 syphilis screening hospitals.70.33%（256/364）of them were female,and 57.69%（210/364）were from obstetrics and gynecology department.309 syphilis screening positive cases were referred to STDs designated hospitals,with the referral rate of 84.89%（309/364）,among which 73.79%（228/309）were female,and the major group was pregnant woman.Those not referred to were mainly caused by doctor＇s forgetfulness.180 cases were successfully referred,with the rate of 58.25%（180/309）.The factors to impact the referral,which had statistically significant difference,were gender,groups and the capacity of screening institutions.Loss in follow-up and diagnosis in the hospitals without STDs clinical capacity were the main reasons for the unsuccessful referrals.Among the successful referrals,the rate of syphilis infection was 83.33%（150/180）and 92.67%（139/150）could get standardized treatment.Conclusion Referral services are of great significance for the syphilis screening positive cases in Zhuhai.It can promote the rate of standardized treatment.The main problem of referral services is the low referral rate.Therefore, training should be strengthened for the staff in private hospitals and general hospitals to improve the referral services.

关 键 词：梅毒血清学阳性者 转介 珠海 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]