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目的分析和评价军队“三位一体”结核病防治新模式的运作机制和成效。方法结核病防治中心于2009年起与医疗体系部队一起建立和逐步完善由部队卫生行政部门、结核病定点医院、卫生所(室)组成的“三位一体”结核病防治新模式。部队卫生行政部门组织协调结核病防治和管理;结核病定点医院具体承担结核病归口诊断和治疗、宣教和培训、密切接触者医学观察工作;基层卫生所(室)承担结核病人追踪、落实治疗和管理。本文就2006年1月～2008年12月与2009年1月～2011年12月“三位一体”模式建立前后的部队结核病防治成效进行比较和评价。结果 “三位一体”模式建立后活动性病例全程治疗率;活动性病例规则服药率;活动性病例1年治愈率;关键月痰检率;官兵结核病防治知识知晓率均较前有明显改善,达到全国结核病防治规划(2001-2010年)的工作指标。结论建立军队“三位一体”结核病防治新模式能取得良好成效,具有一定可行性,适合部队的结核病防治特点。
Objective To analyze and evaluate the operating mechanism and effectiveness of the new model of “Trinity” tuberculosis prevention and control in the military. Methods The TB Control Center established and gradually perfected the new model of “Trinity” prevention and treatment of tuberculosis, which is composed of the military health administrative departments, designated tuberculosis hospitals and clinics (rooms) with the medical system units in 2009. The military health administrative departments organize and coordinate the prevention and control of tuberculosis; the TB designated hospitals bear the sole responsibility for the diagnosis and treatment of TB, the missionary and training, and the medical observation of close contacts; and the grass-roots health clinics (TBs) carry out the follow-up and implementation of treatment and management of TB patients. This article compares and evaluates the effectiveness of tuberculosis prevention and control in the armed forces before and after the establishment of the “Trinity” model from January 2006 to December 2008 and from January 2009 to December 2011. Results The whole treatment rate of active cases after the establishment of the “Trinity” mode was established. The rate of taking active cases and cases, the cure rate of one year of active cases, the rate of key sputum sputum and the awareness rate of tuberculosis prevention and control among officers and soldiers were all significantly improved compared with those before. Achieve the national tuberculosis prevention and control program (2001-2010) indicators of work. Conclusion The establishment of a new model of “Trinity” prevention and treatment of the armed forces can achieve good results, which is feasible and suitable for the prevention and control of tuberculosis in the armed forces.