2021年云南省楚雄州医疗机构伤寒和副伤寒诊断准确性核查  

Accuracy examination of typhoid and paratyphoid fever diagnosis among medical institutions in Chuxiong prefecture of Yunnan province in 2021

作　　者：钱发宝 高丽芬[1] 胡海梅[1] 罗琼梅 江素宏 袁嘉忆 周立景 吴学林[1] QIAN Fa-bao;GAO Li-fen;HU Hai-mei;LUO Qiong-mei;JIANG Su-hong;YUAN Jia-yi;ZHOULi-jing;WU Xue-lin(The Center for Disease Control and Prevention of Chuxiong Prefecture,Chuxiong,Yunnan,675000,China)

机构地区：[1]云南省楚雄州疾病预防控制中心,云南楚雄675000

出　　处：《疾病预防控制通报》2022年第6期11-14,共4页Bulletin of Disease Control & Prevention(China)

摘　　要：目的 了解云南省楚雄州医疗机构伤寒和副伤寒诊断的准确性,分析存在的问题与不足,提出改进措施。方法依据WS 280-2008《伤寒和副伤寒诊断标准》,对辖区医疗机构2020年12月1日至2021年11月30日报告的伤寒和副伤寒病例开展核查。设计调查问卷分别访谈调查医院的检验科医生、临床医生、预防保健科医生,了解该医院的实验室检测能力、临床医生对伤寒和副伤寒诊断标准及疫情规范报告的把握以及院内传染病疫情报告管理制度运行情况。结果共有14家医疗机构报告伤寒和副伤寒病例82例,诊断准确39例、准确率47.56%;大多数病例临床症状不典型,有伤寒和副伤寒特殊体征者仅3例、占3.66%;乡(镇)卫生院仅能开展血细胞常规分析;访谈94名医生,能正确区分伤寒和副伤寒病例分类的7人、正确率7.45%。结论 楚雄州伤寒和副伤寒病例诊断准确率低,临床医生对伤寒和副伤寒诊断标准的掌握水平较低;应加强伤寒和副伤寒等法定传染病诊断标准的培训,加强病原学检测,定期组织开展传染病诊断准确性核查。Objective To understand the accuracy of diagnosis of typhoid and paratyphoid fever in medical institutions in Chuxiong Prefecture of Yunnan Province, and analyze the existing problems and deficiencies, and propose improvement measures. Methods According to Diagnostic Criteria for Typhoid and Paratyphoid(WS 280-2008), the cases with typhoid and paratyphoid fever reported from December 1st, 2020 to November 30th, 2021 were inspected. A questionnaire was designed for interviewing the doctors from laboratory, clinical departments, and preventive and health departments to understand the capacity of laboratory testing, the grasp of diagnostic criteria and the specification report of typhoid and paratyphoid epidemic of clinicians, and the operating status of the infectious disease reporting management system in the hospitals. Results There were 82 cases with typhoid and paratyphoid reported from 14 medical institutions. Of which, 39cases were accurately diagnosed with the accuracy rate of 47.56%. The clinical symptoms were atypical in most of the cases,and the special signs of typhoid and paratyphoid only occurred in 3 cases, accounting for 3.66%. Township(town) hospitals could only conduct blood cell routine analysis. There were 7 doctors could correctly distinguish the categories of typhoid and paratyphoid in 94 interviewees, and the accuracy rate was 7.45%. Conclusions The diagnostic accuracy rate of the cases with typhoid and paratyphoid is low, and the level of grasp of diagnostic criteria for typhoid and paratyphoid is low in the clinicians in Chuxiong prefecture. The training on the diagnostic standards of typhoid and paratyphoid should be strengthened, the etiological exam should be enhanced. It is necessary to carry out the inspection for the accuracy of infectious disease diagnoses.

关 键 词：伤寒 副伤寒 医疗机构 诊断准确率 

分 类 号：R516.3[医药卫生—内科学]