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目的评价综合医院承担城区结核病治管理工作模式的效果。方法通过下达文件,把原来由镇江市疾病控制中心结防所、各综合医院肺科负责的城区结核病现代结核病控制策略(简称DOTS策略)的各项工作全部由医院新成立的结防科承担。结果3年来城区结核病的转诊率由实施前的20%上升到90%;肺结核病人涂阳新登记率由2001年的5.57/10万,上升至2004年的21.57/10万,比2001年提高了387.2%;新发现肺结核病人的查痰率2001年平均为25%,阳性检出率为20%,至2004年底统计肺结核病人查痰率平均已达100%,阳性检出率平均为40.1%,DOTS覆盖率由实施前不足10%上升到95%以上;初治传染性肺结核治愈率达90%以上,复治治愈率达80%。结论定点医院同样可以承担现代结核病控制策略,很好地把结核病的监督管理与规则治疗有机结合起来,在结核病控制工作中发挥重要的作用。
Objective To evaluate the effectiveness of general hospitals in the management of urban tuberculosis management. Methods Through the release of documents, all the urban tuberculosis modern tuberculosis control strategies (referred to as DOTS strategies) that were formerly under the responsibility of the Lung Disease Control Center of the Zhenjiang City Center for Disease Control and the general hospitals were all undertaken by the newly established Department of Hospital Defense. Results In the past three years, the referral rate of tuberculosis in urban areas has risen from 20% before implementation to 90%; the new rate of smear-positive patients with tuberculosis increased from 5.57/100,000 in 2001 to 21.57/100 in 2004, which was higher than in 2001. 387.2%; Newly discovered tuberculosis patients had an average rate of 25% in 2001 and a positive rate of 20%. By the end of 2004, the average rate of sputum tuberculosis patients had reached 100%, and the average positive rate was 40.1%. The coverage of DOTS rose from less than 10% before implementation to more than 95%; the cure rate of newly-acquired infectious tuberculosis reached more than 90%, and the retreatment cure rate reached 80%. Conclusions Fixed-point hospitals can also undertake modern tuberculosis control strategies and organically combine supervision and management of tuberculosis with regular treatment to play an important role in tuberculosis control.