青海省12家县级结核病定点医院初诊患者痰标本质量影响因素分析  

Survey on the factors affecting the quality of sputum specimen concerning suspected tuberculosis cases in 12 tuberculosis hospitals in Qinghai

作　　者：魏於家 马斌忠[1] 武慧荷 蒋明霞[1] 王朝才[1] 郭方明 李珍 马会来[3] WEI Yu-jia;MA Bin-zhong;WU Hui-he;JIANG Ming-xia;WANG Zhao-cai;GUO Fang-ming;LI Zhen;MA Hui-lai(Qinghai Province Center for Disease Control and Prevention,Xinning 810007,China;不详)

机构地区：[1]青海省疾病预防控制中心,西宁810007 [2]青海省人民医院 [3]中国疾病预防控制中心现场流行病学项目部

出　　处：《医学动物防制》2022年第2期140-143,共4页Journal of Medical Pest Control

摘　　要：目的分析青海省县级结核病定点医院初诊患者痰标本质量现状及影响因素,为开展干预措施提出建议。方法选取青海省痰标本质量合格率最低的12家县级结核病定点医院的痰标本、初诊患者及医务人员进行调查分析,以痰标本质量是否合格为因变量,以与痰标本质量有关的其他因素为自变量,通过多因素Logistic回归分析确定主要影响因素。结果痰标本质量总合格率为36.8%(592/1610)。性别为男性、文化程度为小学及以下、咳嗽咳痰症状持续时间低于2周、就诊前有过对症抗生素治疗、认为留痰对自己的诊疗不重要、未掌握深咳方法、无医务人员指导留痰是影响痰标本质量的主要因素,其中认为留痰不重要和无医务人员指导留痰为最主要的危险因素,OR(95%CI)分别为11.853(4.718~29.773)、9.098(4.954~16.706)。参与调查的医务人员中,工作时间低于2年的占64.4%(29/45),未参加过痰标本采集培训的占42.2%(19/45),未能每次都指导患者留痰的占60.0%(27/45)。结论青海省县级结核病定点医院痰标本质量合格率低。应加强对男性、文化程度低、咳嗽咳痰症状持续时间短、有过对症抗生素治疗、对痰标本检查重要性认识不足、未掌握深咳留痰方法患者的关注;加强医务人员对患者的留痰指导。Objective To analyze the current status and influencing factors of the quality of sputum specimens from first-time patients in tuberculosis hospitals in Qinghai Province,and to make recommendations for intervention.Methods The sputum samples,primarypatients and medical staff of 12 tuberculosis hospitals in Qinghai Province with the lowest qualified rate of sputum samples were selected for investigation and analysis.The main influencing factors were identified by multi-factor logistic regression analysis,using whether the sputum specimen quality was statisfactory as the dependent variable and other factors realte to sputum specimen quality as the independent variables.Results The qualified rate of sputum samples was 36.8%(592/1610).Male gender,primary school education or below,cough and sputum symptoms lasting less than 2 weeks,symptomatic antibiotic treatment prior to consultation,belief that sputum retention is not important to one′s care,and lack of medical supervision for sputum retention were the main factors affecting the quality of sputum specimens,with belief that sputum retention was not important and lack of medical supervision for sputum retention being the most important risk factors.The corresponding odds ratios(OR)and 95%confidence intervals(CI)of the above factors were 3.576(1.990-6.428),3.955(2.138-7.315),2.855(1.528-5.333),2.442(1.303-4.577),11.853(4.718-29.773),2.330(1.235-4.396)and 9.098(4.954-16.706).Among the medical staff who participated in the survey,64.4%(29/45)had worked for less than 2 years,42.2%(19/45)had not participated in the training of sputum specimen collection,and 60.0%(27/45)failed to instruct patients to retain sputum samples every time.Conclusion Low quality pass rate of sputum specimens in county-level tuberculosis hospitals.More attention should be paid to the patients who are men,with low educational level,short duration of cough and sputum symptoms,symptomatic antibiotic treatment,who lack of understanding of the importance of sputum specimen examination and do not mast

关 键 词：结核病 初诊患者 痰标本质量 痰涂片检查 影响因素 分析 

分 类 号：R197.3[医药卫生—卫生事业管理] R52[医药卫生—公共卫生与预防医学]