济南市某中学部分肺结核病例发病情况及关联性调查分析  

Investigation and Analysis of Incidence and Orrelation of Some Pulmonary Tuberculosis Cases in a Certain Middle School of Jinan

作　　者：刚桂荣 王京京 滕婉莹 张召军 王宁 于德才 Gang Guirong;Wang Jingjing;Teng Wanying;Zhang Zhaojun;Wang Ning;Yu Decai(Shanghe County Center for Disease Control and Prevention,Shanghe,Shandong,251600,China;不详)

机构地区：[1]山东省济南市商河县疾病预防控制中心,山东商河251600 [2]山东省济南市疾病预防控制中心,山东济南250021

出　　处：《中国初级卫生保健》2023年第8期100-102,共3页Chinese Primary Health Care

摘　　要：目的:对济南市某中学短期内发生的肺结核病例进行调查,分析疫情发生的原因,提出解决问题的方法,探讨控制学校结核病的有效措施。方法:对2021年6—7月济南市某中学集中发生的肺结核病例情况进行描述性分析。对密切接触者和一般接触者进行结核菌素(PPD)试验和胸部X线检查,对其结核感染状况进行筛查。采用χ^(2)检验比较有无结核病例班级、教师与学生之间PPD强阳性率的差异。结果:2021年济南市某中学共报告肺结核病例数8例,其中6例为学生,2例为教师,传染源为初三2班班主任。出现肺结核病例班级学生的PPD试验强阳性率为39.77%,未出现肺结核病例班级学生的PPD试验强阳性率为22.81%,差异有统计学意义(χ^(2)=6.70,P<0.05);初三年级学生PPD强阳性率为43.75%,初三年级教师PPD强阳性率为35.53%,差异无统计学意义(χ^(2)=1.33,P=0.25);第2次扩大筛查人员的PPD强阳性率与首次筛查和第1次扩大筛查人员的PPD强阳性率相比,差异有统计学意义(χ^(2)=26.22,P<0.01)。结论:调查研究显示,发病时间较早、隐瞒教师身份且带病上课的1例病原学阳性肺结核患者是该学校结核病病例多发的主要原因。出现肺结核班级的学生PPD强阳性率明显高于未出现肺结核的班级。OBJECTIVE A survey of pulmonary tuberculosis cases in a middle school in Jinan,to find out the cause of the epi⁃demic,propose solutions to the problem,and discuss effective measures to control the epidemic of tuberculosis in schools.METHODS A descriptive analysis was made on the situation of pulmonary tuberculosis cases in a middle school in Jinan in 2021.Close contacts and general contacts were screened for tuberculosis infection by tuberculin test(PPD)and chest X-ray.The chi-square test was used to compare the relationship between the strong positive rate of tuberculosis patients and non-tuberculosis patients in the class,as well as the relationship between the strong positive rate of tuberculosis in teachers and students.RESULTS In 2021,a total of 8 cases were reported in a middle school in Jinan,among which were 6 students and 2 teachers.The source of infection was the class director of Class 2,Grade 3.According to tuberculin(PPD)test,the strong positive rate of the class with tuberculosis cases was 39.77%,and that of the class without tuberculosis was 22.81%,and the difference was statistically significant(χ^(2)=6.70,P<0.05).The positive rate of tuberculosis was 43.75%in grade 3 students,and 35.53%in grade 3 teachers,the difference was not statistical⁃ly significant(χ^(2)=1.33,P=0.25).The strong PPD positive rate of the second extended screening was compared with that of the first screening and the first extended screening,and the difference was statistically significant(χ^(2)=26.22,P<0.01).CONCLUSION Through investigation and research,the early onset of tuberculosis,concealing the identity of the teacher and a case of etiology posi⁃tive tuberculosis patient in class are the main causes of the outbreak of tuberculosis in the school.The positive rate of the class with tuberculosis was significantly higher than that of the class without tuberculosis.

关 键 词：肺结核 学校 处置 

分 类 号：R197[医药卫生—卫生事业管理]