2018-2023年北京市西城区结核病防治机构登记管理肺结核患者到位前漏报情况分析  

Analysis of under-reporting before arrival of pulmonary tuberculosis patients registered and managed by Tuberculosis Prevention and Control Institutions in Xicheng District,Beijing from 2018 to 2023

作　　者：冯畏 郑海伦 孟炜丽[1] 罗萍 Feng Wei;Zheng Hailun;Meng Weili;Luo Ping(Tuberculosis Prevention and Control Department of Beijing Xicheng Center for Disease Control and Prevention,Beijing 100120,China;Tuberculosis Outpatient Department,Beijing Center for Disease Control and Prevention,Beijing 100035,China)

机构地区：[1]北京市西城区疾病预防控制中心结防科,北京100120 [2]北京市疾病预防控制中心结核病门诊部,北京100035

出　　处：《中国防痨杂志》2025年第4期439-443,共5页Chinese Journal of Antituberculosis

摘　　要：目的:分析北京市西城区结核病防治(简称“结防”)机构登记管理肺结核患者到位前网络传染病报告(简称“网报”)漏报情况,为进一步提高患者发现提供科学依据。方法:数据来源于“中国疾病预防控制信息系统”子系统“结核病信息管理系统”和西城结防机构门诊2018—2023年病案信息。1233例到位前需网报患者按就诊来源分为因症就诊693例和健康体检540例。对因症就诊和健康体检患者进行到位前漏报分析,并对患者到位时影像学表现和病情进行对比分析。结果:1233例患者中887例到位前有网报,346例无网报。因症就诊患者漏报135例,漏报率为19.48%(135/693);健康体检患者漏报211例,漏报率为39.07%(211/540)。因症就诊患者漏报率明显低于健康体检患者,两者比较差异有统计学意义(χ^(2)=57.719,P<0.001)。对比因症就诊和健康体检到位时患者不同影像学表现和相应症状,所占比例分别为病灶累及1~3个部位76.91%(533/693)和90.37%(488/540),空洞38.67%(268/693)和22.22%(120/540),咳嗽咳痰72.15%(500/693)和18.15%(98/540),咯血12.84%(89/693)和0.93%(5/540),其他症状(包括胸痛胸闷、发热、乏力、食欲减退和盗汗等)51.08%(354/693)和9.26%(50/540),差异均具有统计学意义(χ^(2)=38.611、38.084、354.351、61.201、240.982,P值均<0.001)。结论:北京市西城区结防机构中健康体检发现患者的到位前漏报率明显高于因症就诊患者,因症就诊患者比健康体检患者的病情严重,提示需进一步完善结防机构现有督导检查方法,并增设独立体检机构的肺结核网报机制,以进一步提高肺结核患者的发现。Objective:To analyze the under-reporting situation of network infectious disease reports(hereinafter referred to as“network reporting”)of pulmonary tuberculosis patients before registration and management in the tuberculosis prevention and control(referred to as“tuberculosis prevention”)institutions in Xicheng District,Beijing,and to provide a scientific basis for further improvement of patient detection.Methods:The data was from the“Tuberculosis Information Management System”,a subsystem of the“China Information System for Disease Control and Prevention”,and the medical records of the outpatient department of Xicheng tuberculosis prevention institution from 2018 to 2023.A total of 1233 patients who needed network reporting before arrival were divided into 693 cases of symptom-based consultations and 540 cases of health check-ups according to the source of the patients.The under-reporting situation before arrival was analyzed,and the imaging and disease conditions of the patients at the time of arrival were comparatively analyzed.Results:Among the 1233 patients,887 were reported before arrival,and 346 were not reported.There were 135 under-reported cases among the symptom-based consultation patients,with an under-reporting rate of 19.48%(135/693),and 211 under-reported cases among the health check-up patients,with an under-reporting rate of 39.07%(211/540).The under-reporting rate of symptom-based consultation patients was lower than that of health check-up patients,and the difference was statistically significant(χ^(2)=57.719,P<0.001).Comparing the image and symptoms of patients at the time of arrival for symptom-based consultations and health check-ups,the proportions were as follows:the lesion involved 1-3 sites,76.91%(533/693)and 90.37%(488/540);cavities,38.67%(268/693)and 22.22%(120/540);cough and expectoration,72.15%(500/693)and 18.15%(98/540);hemoptysis,12.84%(89/693)and 0.93%(5/540);other symptoms,51.08%(354/693)and 9.26%(50/540).All the differences were statistically significant(χ^(2)=3

关 键 词：结核 肺 病人转诊 漏报 北京市 

分 类 号：R521[医药卫生—内科学]