惠州市基于手机微信APP的结核病管理系统管理模式的实施效果评价  

Evaluation of implementation effect of management model of WeChat APP based tuberculosis management system in Huizhou

作　　者：翁剑峰[1] 陈文杰 刘志东[1] 陈浩[1] 李晓芬 尹庆庆 姚卓城 Weng Jianfeng;Chen Wenjie;Liu Zhidong;Chen Hao;Li Xiaofen;Yin Qingqing;Yao Zhuocheng(Huizhou Occupational Disease Prevention and Control Hospital,Guangdong Province,Huizhou 516000,China)

机构地区：[1]广东省惠州市职业病防治院,惠州516000

出　　处：《结核与肺部疾病杂志》2023年第6期468-474,共7页Journal of Tuberculosis and Lung Disease

基　　金：广东省医学科研基金(B2018257)。

摘　　要：目的:评价惠州市基于手机微信APP的结核病管理系统(简称“微督导”)管理模式的实施效果。方法:采用前瞻性研究方法,纳入惠州市2021年1—12月新发现并登记的1714例符合入组标准的药物敏感肺结核患者,根据患者自愿原则,将其纳入微督导管理组(764例)和常规督导模式管理组(950例)。再按照随机数字表法从两类患者中分别选取观察组(采用微督导方式管理)和对照组(采用常规督导方式管理)各500例,观察并分析两组患者治疗期间接受访视与宣传教育情况,以及治疗依从性(漏服药和复查)、治疗成功和耐药发生情况。结果:观察组接受医务人员访视率[92.60%(463/500)]、宣传教育接受率[97.80%(489/500)]和成功治疗率[97.40%(487/500)]均高于对照组[84.20%(421/500)、85.80%(429/500)和85.20%(426/500)],差异均有统计学意义(χ^(2)=17.202、47.824、46.846,P值均=0.000);脱组率[2.60%(13/500)]、漏服药率[15.81%(77/487)]、耐药发生率[0.40%(2/500)]均低于对照组[14.80%(74/500)、30.98%(132/426)、3.00%(15/500)],差异均有统计学意义(χ^(2)=46.846,P=0.000;χ^(2)=29.644,P=0.000;χ^(2)=10.113,P=0.001);观察组患者第2、5、6个月末查痰率[97.59%(486/498)、97.12%(473/487)、90.96%(443/487)]和第6个月末胸部X线检查率[93.02%(453/487)]均高于对照组[84.88%(421/496)、86.08%(371/431)、78.40%(334/426)、80.98%(345/426)],差异均有统计学意义(χ^(2)=50.275、37.646、28.283、29.883,P值均=0.000)。结论:微督导管理模式可有效提高患者治疗依从性、成功治疗率,并降低耐药发生率,值得推广应用。Objective:To evaluate the implementation effect of WeChat application based tuberculosis management system(referred to as“micro-supervision”)in Huizhou.Methods:A prospective study was conducted,1714 newly registered drug-susceptible pulmonary tuberculosis patients who met the inclusion criteria in Huizhou City from January to December 2021 were allocated to micro-supervision management group(764 cases)and the conventional supervision management group(950 cases),according to the patient’s voluntary principle.According to the table of random sampling numbers,500 cases were randomly selected from the observation group(micro-supervision group)and the control group(conventional supervision group),respectively.The status of receiving medical staff visits,promotion and education,treatment adherence(missed medication and follow-up examination),treatment success,and occurrence of drug resistance were observed for the two groups.Results:The rate of medical staff visits(92.60%(463/500)),promotion(97.80%(489/500)),and the successful treatment rate(97.40%(487/500))among observation group were higher than those of the control group(84.20%(421/500),85.80%(429/500)and 85.20%(426/500)),and the differences were statistically significant(χ^(2)=17.202,47.824,46.846,Ps=0.000).The dropout rate(2.60%(13/500)),missed medication rate(15.81%(77/487)),and drug resistance rate(0.40%(2/500))were all significantly lower than the control group(14.80%(74/500),30.98%(132/426)and 3.00%(15/500)),and the differences were statistically significant(χ^(2)=46.846,P=0.000;χ^(2)=29.644,P=0.000;χ^(2)=10.113,P=0.001).The sputum examination rate(97.59%(486/498),97.12%(473/487),90.96%(443/487))at the end of the 2nd,5th,and 6th,and X-ray examination rate(93.02%(453/487))at the end of the 6th months of treatment in the observation group were higher than those in the control group(84.88%(421/496),86.08%(371/431),78.40%(334/426),80.98%(345/426)),the differences were statistically significant(χ^(2)=50.275,37.646,28.283,29.883;Ps=0.000).Conclusion:The m

关 键 词：结核 手机微信 管理 依从性 访视 复查 

分 类 号：R521[医药卫生—内科学]