昆明市2014-2019年布鲁菌病诊断情况分析  

Diagnosis performance of brucellosis in Kunming from 2014 to 2019

作　　者：洪劲[1] 张荣兵[1] 孟琼[2] 叶青 杨倩 余静[1] HONG Jin;ZHANG Rong-bing;MENG Qiong;YE Qing;YANG Qian;YU Jing(Kunming Center for Disease Control and Prevention,Yunnan650228,China;不详)

机构地区：[1]昆明市疾病预防控制中心,云南650228 [2]昆明医科大学

出　　处：《医学动物防制》2021年第3期272-274,279,共4页Journal of Medical Pest Control

基　　金：国家自然科学基金(81960617);云南省财政厅、云南省卫生计生委2015年重大公共卫生项目中央补助资金(云财社[2015]2020号)。

摘　　要：目的掌握昆明市2014-2019年布鲁菌病(布病)诊断现状,为提高布病诊断质量提供参考依据。方法由疾病监测信息系统中导出2014-2019年现住地址为昆明市布病数据库,结合调查资料,运用发病-诊断间隔、异地就诊和实验室确诊数据分析布病诊断情况。结果昆明市2014-2019年报告布病病例394例,三级医院报告病例占比最高(59.14%),三级医院报告病例比例由2014年的66.67%下降到2019年的37.69%,疾控则由8.33%上升到40.77%。发病-诊断间隔中位数21 d,由2014年的24 d缩短至2019年的22 d。其中14.21%的病例未能在急性期诊断,二级医院急性期诊断比例最高(92.21%)。异地就诊率48.73%,三级医院异地就诊率46.70%,95.83%的异地就诊病例到三级医院就诊,本地就诊占比最高的是疾控(40.59%)。实验室确诊率84.01%,县乡级医疗卫生机构不具备布病检测能力。结论加强县级和基层医疗卫生机构(尤其是高发地区)布病检测和诊断能力,提高医疗服务可及性,早诊断、早治疗,避免慢性化,是当前医疗卫生机构的工作重点。Objective To caputer the currect status of brucellosis diagnosis in Kunming from 2014 to 2019,and provide reference for improving the quality of brucellosis diagnosis.Methods The database of brucellosis with a current address in Kunming was derived from the disease surveillance information system from 2014 to 2019,date on incidence-diagnosis intervals and laboratory confirmation were used in conjunction with survey date to analyse the disgnosis of brucellosis.Results From 2014 to 2019,394 cases were reported around Kunming area,Third-class hospitals reported the highest proportion of cases(59.14%).The proportion of cases reporetd in tertiary hospitals decreased from 66.67% in 2014 to 37.69% in 2019.While CDC increased from 8.33% to 40.77%.The median onset-diagnosis interval of 21 d was reduced from 24 d in 2014 to 22 d in 2019,14.21% of these cases were not diagnosis in the acute phase,The diagnosis rate of acute stage in secondary hospital was the highest(92.21%).The rate of non-local medicial care was 48.73% and non-local medical care was 46.70% in tertiary hospitals,with 95.83% of off-site cases attending tertiary hospitals and the highest proportion of local visits being for CDC(40.59%).Among the reported cases,84.01% of those were laboratory confirmed.County and township levels medical institutions did not have the capacity to detect brucellosis.Conclusion Strengthening the ability of detection and diagnosis brucellosis in medical institutions at the county and primary health care level,improving the aaccess to medical services,early diagnosis,early treatment and avoiding chronicity are the current priority for medical and health institutions.

关 键 词：布鲁菌病 检测 诊断 医疗卫生机构 分析 

分 类 号：R516.7[医药卫生—内科学]