某医院肺结核密接者结核感染筛查结果及其影响因素分析  

Analysis of tuberculosis infection screening results and influencing factors among close contacts of pulmonary tuberculosis in a hospital

作　　者：刘潇[1,2] 熊滨[2,3] 欧莉梅[1,2] 胡前途 黄秋华 劳飞翔 梅仲秋 LIU Xiao;XIONG Bin;OU Limei;HU Qiantu;HUANG Qiuhua;LAO Feixiang;MEI Zhongqiu(Department of Infection Management,Guangxi Academy of Medical Sciences—the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Institute of Infectious Diseases and Critical Care Treatment,Guangxi Academy of Medical Sciences—the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Department of Critical Care Medicine,Guangxi Academy of Medical Sciences—the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]广西医学科学院·广西壮族自治区人民医院感染管理科,广西南宁530021 [2]广西医学科学院·广西壮族自治区人民医院传染病与急危重症救治研究所,广西南宁530021 [3]广西医学科学院·广西壮族自治区人民医院重症医学科,广西南宁530021

出　　处：《右江医学》2023年第12期1076-1081,共6页Chinese Youjiang Medical Journal

基　　金：广西科技计划项目(桂科AD22035101);广西壮族自治区卫生健康委员会重点(培育)实验室建设项目(ZZH2020013)。

摘　　要：目的对某医院医务人员确诊为肺结核后的密接者的筛查结果进行分析,探讨医院工作人员结核病流行情况的控制及预防措施,并分析影响肺结核流行的因素。方法以某医院一名确诊肺结核的实习生的89位密接者作为筛查对象,密接者行结核菌素试验(PPD)和胸片(CR)检查,使用卡方检验,多因素logistic回归等分析方法进行统计学分析。结果89名密接者的PPD试验结果显示强阳性5例,强阳性率为5.62%;CR检查结果显示密接者无阳性体征。医院工作人员是结核病传播的高危人群,不同人员类别及不同文化程度密接人员PPD试验强阳性率差异有统计学意义(P<0.05),护工密接人员PPD试验强阳性率明显高于实习医学生、医生和护士,中专及以下密接人员PPD试验强阳性率明显高于大专或本科和研究生及以上密接人员。多因素logistic回归分析发现人员类型和密接者强阳性存在相关关系,人员类别可能是肺结核流行的影响因素。结论从结核密接者各项筛查结果来看,该结核病例未构成群体环境结核疫情,没有造成传播。人员类型和密切接触者强阳性存在相关关系,同为密切接触者中肺结核在护工群体的传染概率较大,院内应加强结核防护意识,提高身体素质,增强对结核病的抵抗力,特别是护工人群。有条件的医院应定期对医务人员进行体检,以便早期发现结核人员,并采取积极措施予以防控。Objective To analyze the screening results of the contacts after a medical staff in a hospital who were diagnosed with pulmonary tuberculosis,discuss the control and prevention measures of the prevalence of tuberculosis among hospital staff,and thus analyze factors affecting the prevalence of pulmonary tuberculosis.Methods 89 close contacts of an intern diagnosed with pulmonary tuberculosis from a certain hospital were selected as screening subjects,and the close contacts underwent purified protein derivative(PPD)and chest X-ray(CR)examination,and statistical analysis was conducted by chi square test,multivariate logistic regression,and other analysis methods.Results The PPD test results of 89 close contacts showed 5 strong positive cases,with a strong positive rate of 5.62%;CR examination results showed that close contacts had no positive signs.Hospital staff were at high risk of tuberculosis transmission,and there was statistically significant difference in the strong positive rate of PPD test among close contacts of different personnel types and educational levels(P<0.05).The strong positive rate of PPD test of nursing assistants among close contacts was significantly higher than that of interns,doctors,and nurses.The strong positive rate of PPD test in close contacts of vocational school and below was significantly higher than that of close contacts of vocational college or undergraduate and graduate students and above.Multivariate logistic regression analysis found a correlation between personnel types and strong positive close contacts,and personnel types may be influencing factor of the prevalence of pulmonary tuberculosis.Conclusion According to the results of various screening of tuberculosis close contacts,the tuberculosis case does not constitute the epidemic situation of tuberculosis in the group environment and does not cause transmission.There is a correlation between the types of personnel and the strong positive rate of close contacts,and among close contacts,tuberculosis has a high probability of

关 键 词：医务人员 结核病 密接 筛查分析 

分 类 号：R521[医药卫生—内科学]