依托基本公共卫生服务对老年人开展肺结核主动筛查策略的可行性研究  

Study on the feasibility of active tuberculosis screening strategy for the elderly based on public health service

作　　者：吴塔娜 李玉红 刘小秋[3] Wu Tana;Li Yuhong;Liu Xiaoqiu(Tuberculosis Prevention and Control Department,Inner Mongolia Autonomous Region Comprehensive Disease Control and Prevention Center,Hohhot 010080,China;China Epidemiology Training Program,Beijing 100050,China;Monitoring and Evaluation Department,National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]内蒙古自治区综合疾病预防控制中心结核病防治科,呼和浩特010080 [2]中国疾病预防控制中心现场流行病学培训项目,北京100050 [3]中国疾病预防控制中心结核病预防控制中心监测评价部,北京102206

出　　处：《中国防痨杂志》2023年第4期372-376,共5页Chinese Journal of Antituberculosis

基　　金：开展老年人和糖尿病患者主动发现肺结核方法的可行性和效果的研究(CS-2020-5)。

摘　　要：目的:评价依托基本公共卫生服务对老年人进行肺结核可疑症状筛查和结核病检查的可行性。方法:采用回顾性调查法,收集“依托基层医疗卫生机构在老年人中开展结核病主动筛查”项目实施现场河南省3个县和湖北省3个县(市)2020年7—12月65岁及以上老年人相关信息,包括基本情况、参加体检/随访情况、症状筛查情况、肺结核可疑症状者转诊情况及肺结核确诊情况等,并分析肺结核主动筛查策略效果。结果:研究地区65岁及以上老年人共计349842名,其中,324598名进行了肺结核可疑症状筛查,321383名筛查记录有效,实际筛查率为91.87%(321383/349842)。共筛查出1466例肺结核可疑症状者,其中,1290例前往医疗机构进行结核病检查,就诊率为87.99%(1290/1466)。经检查,共诊断出54例活动性肺结核患者,其中,53例为有可疑症状者,1例无肺结核相关症状因其他疾病就诊确诊为肺结核,结核病检出率为16.80/10万(54/321383)。2020年6个县(市)共发现65岁及以上老年肺结核患者547例,其中,通过基层主动症状筛查发现54例,主动症状筛查策略的实施使老年肺结核患者发现数增长了10.95%[54/(547-54)]。结论:依托基层医疗卫生机构在老年人中开展结核病主动筛查具有可行性,且取得一定效果。Objective:To evaluate the feasibility of screening suspicious symptoms of pulmonary tuberculosis(PTB)and TB examination for the elderly relying on public health services.Methods:The retrospective survey method was used to collect the relevant information of the elderly aged 65 and above from July to December 2020 in three counties(cities)of Henan Province and three counties(cities)of Hubei Province at the implementation site of the project of“TB active screening among the elderly relying on primary medical and health institutions”,including basic information,physical examination or follow-up,symptom screening,referral and diagnosis of suspicious symptoms of PTB,and analysis of the effect of active screening strategy for PTB.Results:A total of 349842 people aged 65 and above in the above areas were included,of which 324598 were screened for suspicious symptoms of PTB,321383 had valid screening records,and the actual screening rate was 91.87%(321383/349842).A total of 1466 cases of suspected symptoms of PTB were screened out,of which 1290 cases went to medical institutions for PTB examination.The examination rate of symptomatic PTB was 87.99%(1290/1466).Fifty-four active PTB patients were diagnosed,of which 53 had suspicious symptoms,and one had no symptoms related to PTB.The detection rate of PTB was 16.80/100000(54/321383).In 2020,a total of 547 cases of PTB patients aged 65 years and above were found in 6 counties(cities),of which 54 cases were found through grass-roots active symptom screening.The implementation of active symptom screening strategy increased the number of elderly PTB patients by 10.95%(54/(547-54)).Conclusion:It is feasible and effective to carry out active PTB screening among the elderly by relying on primary medical and health institutions.

关 键 词：结核 肺 老年人 卫生服务研究 策略 实验性 回顾性研究 

分 类 号：R52[医药卫生—内科学] R195[医药卫生—临床医学]