中国西部地震灾区灾后肺结核防控策略与效果
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摘要
目的探讨震后绵阳市肺结核综合防治体系对肺结核患者的检出率、治愈率、病死率、复发率的影响。方法建立以绵阳传染病医院为医疗救治中心的综合肺结核防控及救治网络;对灾区某区域人群进行拉网式排查;建立对重症肺结核"三集中"救治模式;专业人员全程督导下的规范化的标准化疗和专业管理体系。结果 2008-2010年绵阳地区检出率(发病率)分别为90.96/10万、81.73/10万、76.42/10万;痰菌涂阳率分别为42.15%、51.68%、55.84%;肺结核病死率分别为0.51%、0.34%、0.27%;新涂阳肺结核患者2008-2010年治愈率分别为86.81%、92.59%、93.56%。结论建立政府投入、社会多部门参与、发挥基层三级结防网络优势互补、医防合作、拉网式筛查、实施"三集中"救治、专业督导人员指导的督导短程化疗(DOTS)等综合防控措施,对提高结核病人发现率、提高病人治疗管理质量和保持高治愈率是行之有效的,应大力推广。
Objective To explore the effect of comprehensive prevention and control system for pulmonary tuberculosis(PTB) on detection rate,curative rate,mortality rate and recurrent rate of PTB patients in Mianyang City after earthquake.Methods We established the network with Mianyang Hospital for Infectious Diseases as the center for comprehensive prevention and treatment of PTB.Dragnet investigation of PTB was conducted in post-disaster areas.The rescue mode of Three Concentrations was built for patients with severe PTB.With the professional management system,whole processes of DOTS supervision were normalized by specialized personnel.Results The incidence rates of PTB in Mianyang areas from 2008 to 2010 were 90.96/100,000,81.73/100,000,and 76.42/100,000,respectively.The sputum smear positive rates from 2008 to 2010 were 42.15%,51.68%,and 55.84%,respectively.The fatality rates of PTB cases from 2008 to 2010 were 0.51%,0.34%,and 0.27%,respectively.The curative rates of new smear positive PTB cases during the period of 2008-2010 were 86.81%,92.59%,and 93.56%,respectively.Conclusions The mode of PTB prevention and control and comprehensive countermeasures in Mianyang areas are highly effective,which deserve to be popularized.
Objective To explore the effect of comprehensive prevention and control system for pulmonary tuberculosis(PTB) on detection rate,curative rate,mortality rate and recurrent rate of PTB patients in Mianyang City after earthquake.Methods We established the network with Mianyang Hospital for Infectious Diseases as the center for comprehensive prevention and treatment of PTB.Dragnet investigation of PTB was conducted in post-disaster areas.The rescue mode of Three Concentrations was built for patients with severe PTB.With the professional management system,whole processes of DOTS supervision were normalized by specialized personnel.Results The incidence rates of PTB in Mianyang areas from 2008 to 2010 were 90.96/100,000,81.73/100,000,and 76.42/100,000,respectively.The sputum smear positive rates from 2008 to 2010 were 42.15%,51.68%,and 55.84%,respectively.The fatality rates of PTB cases from 2008 to 2010 were 0.51%,0.34%,and 0.27%,respectively.The curative rates of new smear positive PTB cases during the period of 2008-2010 were 86.81%,92.59%,and 93.56%,respectively.Conclusions The mode of PTB prevention and control and comprehensive countermeasures in Mianyang areas are highly effective,which deserve to be popularized.
引文
[1]中华人民共和国卫生部,中国疾病预防控制中心.中国结核病防治规划实施工作指南[M].北京:中国协和医科大学出版社,2009:1.
[2]程红群.结核病护理210问[M].北京:科技文献出版社,2001:23-44.
[3]王黎霞,成诗明,徐敏,等.加强结防机构与医院的合作提高肺结核病人发现试点报告[J].中国防痨杂志,2007,29(6):479-482.
[4]王陇德.结核病防治[M].北京:中国协和医科大学出版社,2004:133.
[5]李仁忠,李海涛,傅国荣.结防机构与医院合作提高肺结核病患者发现研究[J].预防医学情报杂志,2009,25(3):173-176.
[6]闫化奎,杨太华,杨津民.肺结核病人转诊相关问题分析[J].中国防痨杂志,2008,30(3):221-222.
[7]陈荣,彭东东,王冬敏.综合医院转诊对提高结核病人发现水平的分析[J].中国防痨杂志,2006,28(3):144-145.
[8]赵蓉.深圳市肺结核病易患影响因素的调查研究[J].实用预防医学,2005,12(5):1042-1043.
[9]杨坤云,何新国.507例老年肺结核病例分析[J].实用预防医学,2003,10(1):73-74.
[2]程红群.结核病护理210问[M].北京:科技文献出版社,2001:23-44.
[3]王黎霞,成诗明,徐敏,等.加强结防机构与医院的合作提高肺结核病人发现试点报告[J].中国防痨杂志,2007,29(6):479-482.
[4]王陇德.结核病防治[M].北京:中国协和医科大学出版社,2004:133.
[5]李仁忠,李海涛,傅国荣.结防机构与医院合作提高肺结核病患者发现研究[J].预防医学情报杂志,2009,25(3):173-176.
[6]闫化奎,杨太华,杨津民.肺结核病人转诊相关问题分析[J].中国防痨杂志,2008,30(3):221-222.
[7]陈荣,彭东东,王冬敏.综合医院转诊对提高结核病人发现水平的分析[J].中国防痨杂志,2006,28(3):144-145.
[8]赵蓉.深圳市肺结核病易患影响因素的调查研究[J].实用预防医学,2005,12(5):1042-1043.
[9]杨坤云,何新国.507例老年肺结核病例分析[J].实用预防医学,2003,10(1):73-74.
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