结核病防治“新疆模式”对肺结核患者延迟情况的影响分析  

Impact of tuberculosis control"Xinjiang model"on the delay of pulmonary tuberculosis patients

作　　者：王明哲 杨璐鹭 王新旗[2] 王森路 毕洪波 WANG Mingzhe;YANG Lulu;WANG Xinqi;WANG Senlu;BI Hongbo(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830011,China;不详)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆维吾尔自治区疾病预防控制中心结核病与麻风病防治中心 [3]新疆维吾尔自治区卫生健康委保健中心 [4]新疆维吾尔自治区疾病预防控制局

出　　处：《中国国境卫生检疫杂志》2025年第1期74-81,105,共9页Chinese Journal of Frontier Health and Quarantine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项(WJWY-202238,WJWY-202242);新疆维吾尔自治区科学技术协会青年人才托举工程项目(RCTJ42)。

摘　　要：目的分析“新疆模式”实施前后新疆肺结核患者延迟情况,探究“新疆模式”对患者延迟的影响,为完善结核病防治工作提供科学依据。方法通过中国疾病预防控制信息系统的子系统“结核病信息管理系统”,按照现住址导出2011—2022年登记管理的新疆肺结核患者病案信息,采用描述流行病学方法分析“新疆模式”实施前后患者就诊延迟、诊断延迟、治疗延迟和总延迟,使用Cochran-Armitage test比较不同年份各类延迟的趋势变化,用卡方检验比较“新疆模式”前后各类延迟率的变化。结果“新疆模式”实施前(2011—2017年)患者就诊延迟率、治疗延迟率、总延迟率呈下降趋势(Z=-44.513、-54.849、-46.698,P<0.05),诊断延迟率呈上升趋势(Z=11.431,P<0.05);实施后(2018—2022年)患者就诊延迟率、诊断延迟率、治疗延迟率、总延迟率均呈下降趋势(Z=-62.192、-27.213、-34.885、-71.244,P<0.05),就诊延迟率、治疗延迟率、总延迟率比实施前下降(χ^(2)=5725.095、636.603、5542.940,P<0.05),诊断延迟率略有升高(χ^(2)=24.175,P<0.05)。患者总延迟天数由实施前38(22,65)d下降至实施后的31(15,61)d(P<0.05),其中就诊延迟天数由31(15,55)d下降至25(8,43)d(P<0.05),诊断延迟天数由2(0,9)d下降至1(0,8)d(P<0.01)。结论“新疆模式”的实施有效降低了新疆肺结核患者就诊延迟、诊断延迟和治疗延迟,是控制肺结核疫情的重要措施之一。Objective To analyze the delay of pulmonary tuberculosis patients before and after the"Xinjiang Tuberculosis Control Model"conducting,to investigate the impact of"Xinjiang Model"on the delay of patients,and to provide scientific basis for the improvement of pulmonary tuberculosis prevention and control.Methods The case information of pulmonary tuberculosis registered and managed in Xinjiang from 2011 to 2022 was exported according to their current addresses from China Information System for Disease Control and"Prevention-Tuberculosis Information Management System".Descriptive epidemiology was employed to analyze the patient,diagnosis,treatment and total delay before and after the implementation of"Xinjiang Model".The Cochran-Armitage test was employed to assess the evolution of each type of delay over time,while the chi-square test was utilized to evaluate the shift in the prevalence of each type of delay before and after the implementation of"Xinjiang Model".Results Before"Xinjiang Model"implementation(2011-2017),the rates of the patient,delayed treatment and total delay showed a decreasing trend(Z=-44.513,-54.849,-46.698,P<0.05),while the rate of diagnosis delay showed an increasing trend(Z=11.431,P<0.05).The patient,diagnosis,treatment and total delay rate showed a decreasing trend(Z=-62.192,-27.213,-34.885,-71.244,P<0.05)after"Xinjiang Model"(2018-2022).The patient,treatment and total delay rate exhibited a reduction when compared with the pre-"Xinjiang Model"(χ^(2)=5725.095,636.603,5542.940,P<0.05),while the diagnostic delay rate exhibited a slight increase(χ^(2)=24.175,P<0.05).The total patient delay days decreased from 38(22,65)to 31(15,61)days(P<0.05),the patient delay decreased from 31(15,55)days to 25(8,43)days(P<0.05),diagnosis delay decreased from 2(0,9)days to 1(0,8)days(P<0.01).Conclusion The implementation of"Xinjiang Model"had effectively reduced the patient,diagnosis and treatment delays of pulmonary tuberculosis patients in Xinjiang,and it was one of the important measures to control pulmonary

关 键 词：肺结核 预防和控制 延迟 结核病控制 新疆模式 

分 类 号：R184.66[医药卫生—流行病学]