泰州市实施结核病分级诊疗和综合防治成效分析  

Effectiveness of the service mode of TB hierarchical diagnosis and integrated control and prevention implemented in Taizhou City

作　　者：缪昌东 张洵[1] 陈静娟[1] MIAO Changdong;ZHANG Xun;CHEN Jingjuan(Taizhou Center for Disease Control and Prevention,Taizhou,Jiangsu 225300,China)

机构地区：[1]江苏省泰州市疾病预防控制中心

出　　处：《中国农村卫生事业管理》2019年第11期823-826,共4页Chinese Rural Health Service Administration

摘　　要：目的分析2017-2018年期间泰州市实施结核病分级诊疗和综合防治服务模式成效,进一步提高结核病防治工作质量。方法总结2015-2018年期间泰州市结核病防治工作主要指标完成情况,对2017-2018年期间实施结核病分级诊疗和综合防治服务模式所采取的主要措施和方法以及分级诊疗指标完成情况进行重点分析。结果至2018年,泰州市普通肺结核患者在县(区)级定点医疗机构治疗率93.8%,肺结核病原学阳性率51.0%,病原学阳性分子生物学耐药检测率94.6%,耐多药肺结核纳入治疗率71.4%,耐多药肺结核治疗成功率52.6%。结论 2017-2018年期间,泰州市通过完善分级诊疗、应用GeneXpert MTB/RIF新诊断技术、将结核病防治和基本公共卫生服务项目结合等综合措施,肺结核患者发现、诊治和随访管理工作质量得到提高。今后仍应加强对耐多药(利福平耐药)肺结核防治工作,利福平耐药病人治疗救助待遇亟待提高。Objective To analyze the implementation effectiveness of the service mode of tuberculosis(TB) hierarchical diagnosis and integrated control and prevention in Taizhou City from 2017 to 2018, and to improve the quality of TB control and prevention. Methods We summarized the completion of the main indicators of TB control and prevention in Taizhou City during the period of 2015-2018, and focused on the analysis of the measures and methods adopted during the implementation of the service mode of TB hierarchical diagnosis and integrated control and prevention in the years of 2017-2018, as well as the achievement of hierarchical diagnosis indicators during the same period. Results By 2018, the treatment rate of ordinary TB patients at county(district) level, the positive rate of TB etiology, the positive drug resistance test rate of etiology, the included treatment rate of multi-drug-resistant tuberculosis and the success rate of multi-drug-resistant tuberculosis treatment were 93.8%, 51.0%, 94.6%, 71.4%, and 52.6%, respectively. Conclusions From 2017 to 2018, the quality of detection, diagnosis and follow-up management of TB patients was improved through the improvement of hierarchical diagnosis and treatment, the application of GeneXpert MTB/RIF new diagnostic techniques, and the combination of TB treatment, control and prevention with basic public health services. In the future, it is necessary to strengthen the prevention and treatment of multi-drug-resistant(rifampicin-resistant) tuberculosis, and to promote the assistance for treatment of patients with rifampicin resistance.

关 键 词：结核病 防治 分级诊疗 

分 类 号：R521[医药卫生—内科学] R183[医药卫生—临床医学]