广东省英德市2010-2020年肺结核患者诊断延误情况分析  

Analysis of Diagnosis delay of Patients with pulmonary tuberculosis in Yingde City,Guangdong from 2010 to 2020

作　　者：卓文基 张建辉 罗济伦 廖庆华 余美玲 杨伟凌 陈文翰[3] 钟耐容 钟粤相 ZHUO Wenji;ZHANG Jianhui;LUO Jilun;LIAO Qinghua;YU Meiling;YANG Weiling;CHEN Wenhan;ZHONG Nairong;ZHONG Yuexiang(Center for Tuberculosis Control of Guangdong Province,Guangzhou 510630,China;不详)

机构地区：[1]广东省结核病控制中心,广州510630 [2]英德市慢性病防治院,广东英德513000 [3]广州市胸科医院,广州510095

出　　处：《实用医学杂志》2023年第11期1364-1368,共5页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:C2020043);“艾滋病和病毒性肝炎等重大传染病防治”国家科技重大专项(编号:2018ZX10715004)。

摘　　要：目的分析结核病患者诊断延误情况及其影响因素,为区域性结核病控制措施的持续改进提供科学依据。方法从“中国疾病预防控制信息系统”子系统“结核病管理信息系统”中导出广东省英德市2010-2020年新发肺结核患者网报资料,回顾性分析该地区11年的肺结核患者诊断延误(从症状发生到肺结核确诊时间>28 d者)总体情况、年间变化趋势以及性别、年龄、居住地域及就诊医疗机构等因素的可能影响。结果(1)英德市11年间共报告新发肺结核病11973例,其中3189例患者(26.63%)存在诊断延误;以第29天开始计算诊断延误时间,其诊断延误时间中位数为17 d。(2)11年间诊断延误率除2010、2011和2020年高达约30%外,其他年份均在22.35%~26.65%的较窄范围内波动;2010-2014年诊断延误时间中位数呈逐年上升趋势,2014年达33 d峰值,其后的6年呈现总体下降趋势,2018年为9 d最低值。(4)≥60岁患者组诊断延误率为22.61%,低于其他年龄组(P=0.000);慢性病防治院就诊患者诊断延误率为62.89%,远高于其他就诊医疗单位(P=0.000);市区、郊区、农村等不同居住地域患者诊断延误率依次升高,且差异显著(P=0.000)。男女性别间则差异无统计学意义(P=0.462)。(4)不同分类组别的诊断延误时间中位数分别为:男、女患者17、16 d;<18岁、18~44岁、45~59岁和≥60岁各年龄组患者10、13、18、20 d;郊区、农村、市区患者19、17、16 d;综合医疗机构、镇卫生院、监狱医院、慢性病防治院报告患者20、15、12、8 d。结论近年来该地区结核病患者诊断延误总体情况不断向好,但患者年龄、居住地域、就诊医疗机构为诊断延误重要影响因素,必须相宜施策。ed from Tuberculosis Information Management System of China Information System for Disease Control and Prevention.Furthermore,the general levels trend and influencing factors(including gender,age,residence,medical institution of providing diagnosis,etc)of diagnosis delay,which defined as more than 28 days from the date of symptom onset to the date of diagnosis,were retrospectively analyzed during eleven years.Results(1)The total number of new pulmonary tuberculosis cases registered was 11973 cases,and diagnosis delay occurred in 3189 cases(accounting for 26.63%).And the median time of diagnosis delay was 17 days,which this time was calculated from the 29th day of symptom start date to the clear diagnosis date.(2)The ratio of diagnosis delay were about 30%in 2010,2011 and 2020 and that of the other years were fluctuating between 22.35%~26.65%.The trend of median time of diagnosis delay was increased year by year in 2010-2014 and median time of diagnosis delay jumped to a peak of 33 days in 2014.Fortunately,the trend in subsequent 6 years was a general decline and the minimum of median time of diagnosis delay was 9 days in 2018.(3)The ratio of diagnosis delay in≥60 years group was 22.61%and significantly lower than other ages groups(P=0.000).The ratio of diagnosis delay of cases living in district,suburban,rural increased in turn and presented significant difference(P=0.000)among them.But,there was no significant difference between male and female(P=0.462).(4)The median time of diagnosis delay were 17 days and 16 days for male and female and 10,13,18 and 20 days for cases of<18,18~44,45~59 and≥60 age groups respectively.It were 19,17,16 days for cases from suburbs,rural and urban and 20,15,12 and 8 days for cases visiting to comprehensive medical institu-tions,town health center and prison hospitals,chronic disease prevention hospitals respectively.Conclusion The overall situation of diagnosis delay for pulmonary tuberculosis have obtained continuous improvement in Yingde City,Guangdong.However its major influe

关 键 词：肺结核 诊断延误 英德市 

分 类 号：R521[医药卫生—内科学] R181.8[医药卫生—临床医学] R183.3