我国结核病关爱行动试点项目基线调查分析  

Baseline survey and analysis of tuberculosis care pilot programme

作　　者：王云霞[1] 孟庆琳[2] 刘二勇[2] 周林[2] Wang Yunxia;Meng Qinglin;Liu Eryong;Zhou Lin(Department of Tuberculosis Control and Prevention,Bao’an Chronic Disease Prevention and Cure,Shenzhen 518101,China;National Center for Tuberculosis Control and Prevention,National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Chinese Centre for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]深圳市宝安区慢性病防治院结核病防制科,深圳518101 [2]中国疾病预防控制中心传染病溯源预警与智能决策全国重点实验室结核病预防控制中心,北京102206

出　　处：《中国防痨杂志》2024年第3期325-332,共8页Chinese Journal of Antituberculosis

基　　金：中央财政结核病防治项目(232811结核业务日常运转)。

摘　　要：目的:分析“我国结核病关爱行动试点项目”首批40个试点县(区)实施前的结核病防治工作基本情况,为后续实施效果的评估及相关措施的推广提供基线数据。方法:2023年4—6月,中国疾病预防控制中心结核病控制中心向首批实施试点项目的15个省的40个试点县(区)结核病防治机构发放统一的半结构化电子版调查问卷,了解并分析项目开始前一年(即2022年)试点县(区)结核病定点医疗机构的服务能力、结核病患者人文关怀和重点人群筛查等措施的开展情况。结果:40个试点县(区)定点医疗机构以综合医院为主[23家(57.50%)],其次是专科医院[8家(20.00%]和疾病预防控制机构[6家(15.00%)]。共有结核病防治人员1017名,每家配备专业人员范围[中位数(四分位数)]为3~64名[19.5(12.5,34.0)名],以门诊和住院医生、护理人员为主[分别为326名(32.05%)和225名(22.12%)],其次为影像科医生和实验室人员[分别为187名(18.39%)和134名(13.18%)]。共报告结核病患者10123例,包括9980例(98.59%)肺结核[包括病原学阳性患者6326例(63.39%)]和143例(1.41%)肺外结核,病原学阴性肺结核的诊断总符合率为85.69%(629/734),但对气管支气管结核的诊断符合率仅有17.86%(5/28)。40个试点县(区)均开展了抗酸杆菌涂片显微镜检查和结核菌素皮肤试验(PPD试验),开展分枝杆菌分离培养、结核分枝杆菌核酸检测和抗结核药物耐药筛查的县(区)分别有39个(97.50%)、37个(92.50%)和32个(80.00%),但开展重组结核分枝杆菌融合蛋白和γ-干扰素释放试验的仅分别有16个(40.00%)和19个(47.50%);开展X线摄影检查、CT检查、人工智能诊断阅片和远程会诊等技术的分别有39个(97.50%)、31个(77.50%)、14个(35.00%)和23个(57.50%)。17个(42.50%)县(区)应用了信息化手段管理患者,15个(37.50%)县(区)提供了交通或营养补助,但开展营养评估和支持治疗、心理支持的均不足30%;36个(90.00%)县(区)Objective:To analyze the tuberculosis prevention and control status of the first 40 pilot counties of the tuberculosis care action project before implementation,and provide baseline data for the implementation effect evaluation.Methods:From April to June 2023,the National Center for Tuberculosis Control and Prevention of China CDC issued a unified semi-structured electronic questionnaire to 40 pilot counties from 15 provinces which were the first batch to implement the“Tuberculosis Care Action Pilot Project”(hereinafter referred to as the“pilot project”),to understand and analyze the service capacity of tuberculosis designated medical institutions,and implementation of measures such as humanistic care for tuberculosis patients and screening for tuberculosis key populations in pilot counties before the start of the pilot project(in 2022).Results:Among the 40 pilot counties,tuberculosis designated medical institutions were mainly composed of comprehensive hospitals(23(57.50%)),followed by specialized hospitals(8(20.00%))and centers for disease control and prevention(6(15.00%)).There were total 1017 tuberculosis prevention and control personnel in designated medical institutions of 40 counties(with a median of 19.5(12.5,34.0)each,range 3 to 64),mainly composed of outpatient and resident doctors(326(32.05%)),followed by nursing personnel(225(22.12%)),imaging doctors and laboratory personnel(187(18.39%)and 134(13.18%)respectively).A total of 10123 tuberculosis patients were reported,including 9980 patients(98.59%)of pulmonary tuberculosis(including 6326(63.39%)etiology positive patients)and 143 patients(1.41%)of extrapulmonary tuberculosis.The proportion of etiology negative pulmonary tuberculosis meeting clinical diagnosis standard was 85.69%(629/734)overall,however,the proportion of etiology negative tracheobronchial tuberculosis meeting clinical diagnosis standard was only 17.86%(5/28).Forty pilot counties all conducted acid fast bacterial smear microscopy and PPD tests.Among them,39(97.50%),37(92.50%),and

关 键 词：结核 试点项目 问卷调查 基线调查 

分 类 号：R52[医药卫生—内科学]