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目的了解浙江省新发肺结核患者发现延误的影响因素,为肺结核的早期控制提供科学依据。方法采用回顾性研究方法收集浙江省2009年1月1日—12月31日确诊登记的31 287例新发肺结核患者病案资料,分析患者发现延误的影响因素。结果浙江省新发肺结核患者就诊延误、诊断延误和发现延误时间中位数分别为17、1和21 d,就诊延误、诊断延误和发现延误率分别为55.66%、7.06%和62.91%;多因素logistic回归分析结果表明,羁押人群、发现地区地形为山地/岛屿、涂阳和重症患者是浙江省新发肺结核患者发现延误的危险因素;男性、15～59岁、学生/儿童、教师/医务人员/职员、服务行业人员、其他职业人员、省外流动户籍、患者来源为健康检查/转诊/追踪、发现地区地形为盆地/丘陵、诊治单位为定点医院是浙江省新发肺结核患者发现延误的保护因素。结论新发肺结核患者就诊延误时间明显较诊断延误长;性别、年龄、职业、户籍、是否羁押人群、患者来源、发现地区地形、诊治单位类型、诊断结果、是否重症是浙江省新发肺结核患者发现延误的影响因素。
Objective To understand the influencing factors of delayed diagnosis of newly diagnosed pulmonary tuberculosis in Zhejiang Province and provide scientific evidence for the early control of pulmonary tuberculosis. Methods A retrospective study was conducted to collect the medical records of 31 287 newly diagnosed pulmonary tuberculosis cases diagnosed in Zhejiang Province from January 1 to December 31, 2009 and to analyze the influencing factors of patients’ delayed diagnosis. Results The median delay in diagnosis, delay of diagnosis and delay in diagnosis of newly diagnosed pulmonary tuberculosis patients in Zhejiang Province were 17, 1 and 21 days respectively. The delay in treatment, diagnosis delay and discovery delay were 55.66%, 7.06% and 62.91% respectively. Multivariate The results of logistic regression analysis showed that in detention population, the terrain of mountainous / islands was found in the area, and smear-positive and critically ill patients were the risk factors of delayed diagnosis in newly diagnosed pulmonary tuberculosis patients in Zhejiang province. Male, 15-59 years old, student / child, teacher / medical staff / Staff, service industry personnel, other professionals, migrant population outside the province, the source of the patient is health check / referral / follow-up and found that the terrain is the basin / hill, the diagnosis and treatment unit is the designated hospital is the discovery of new pulmonary tuberculosis patients in Zhejiang Province Protection factors. Conclusions The delay in the treatment of patients with newly-diagnosed pulmonary tuberculosis is significantly longer than that of the diagnosis. The sex, age, occupation, household registration, whether or not the patients are in custody, the source of the patients, the geographical topography, the types of diagnosis and treatment units, the diagnosis results, Factors affecting the delay.