医疗机构在结核病控制工作中的作用与影响

目的分析湖南省医疗机构肺结核病例转诊和结核病防治机构进行病例追踪后诊断情况,评价医疗机构在结核病控制工作中的作用和对全省结核病控制工作的影响。方法对2005年湖南省中国结核病控制工作月报表数据进行统计,分析医疗机构转诊到位病例中,不同类型肺结核病例报告数和构成比、结核病防治机构病例追踪到位率、不同类型追踪到位病例中肺结核病例诊断情况。结果2005年全省医疗机构报告肺结核病例24145例,除去辖区外和住院病例外,转诊到结核病防治机构9534例(48.8%),其中涂阳病例转诊到位率最高,占同类病例的63.5%,菌阴病例和未痰检病例分别占同类病例的42.4%和48.2%。结核病防治机构对未到位的病例进行追踪后到位5086例,总到位率为60.6%。在追踪到位的病例中,发现涂阳病例1419例(27.9%)和菌阴病例1817例(35.7%)。追踪到位的病例中经进一步检查属于非结核排除病例为29.2%,其中医疗机构报告的未痰检病例中属于非结核排除病例占34.6%。结论做好医疗机构肺结核病例的诊断、报告和转诊工作,对全省结核病控制工作将产生很大的社会效益和经济效益。应不断加强医疗机构和结核病防治机构的合作,促进全省结核病控制工作的持续发展。

Effect and impact of general hospital in tuberculosis control

Objective To analyze the status of case referring,tracing and diagnosis of pulmonary tuberculosis(TB) in Hunan Province and to evaluate the effect and impact of general hospitals in TB control in Hunan Province.Methods The case information in 2005 Hunan Provincial in monthly report of Chinese National TB Control was statistically analyzed.The numbers and the proportion of cases in different categories reported from general hospitals,the arrival rate of the referred cases,the arrival rate of traced cases,the diagnosis and notification of the cases arrived by tracing were analyzed.Results 24145 pulmonary TB cases were reported by general hospitals to the internet-based reporting system in 2005.Among them,9534 were referred to TB dispensary.The proportion of the cases arrived by referral out of the cases which should arrive was 48.8% and smear positive case was 63.5% and smear negative case was 42.4% and no sputum examination was 48.2%.After tracing by the TB dispensary,5086 cases arrived in TB dispensary with the total arrival rate of 60.6%.Among the cases arrived through tracing,1419 smear positive cases(27.9%) and 1817 smear negative cases(35.7%) were detected. After further examination,among the cases arrived after tracing,29.2% were excluded from TB and among the cases without sputum microscopy 34.6% were excluded from TB.Conclusion Further improving the diagnosis and reporting and referring in general hospitals will bring significant social and economic effect to TB control in Hunan Province.Cooperation between general hospital and TB institute should be strengthened and the performance of TB control in Hunan Province should be promoted.