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目的研究绩溪县肺结核病发病特征,为制定控制对策提供科学依据。方法对绩溪县1997~2005年报告的肺结核病例进行流行病学分析,对县结核病专科门诊病人的管理和新发涂阳病人的转归进行分析研究。结果1997~2005年绩溪县肺结核病平均发病率为73.39/10万,占法定甲乙类传染病发病总数的35.08%(1 198/3 415),且所占比重呈逐年增高的趋势;肺结核病人中绝大多数为农民,占发病总数的72.61%;各年龄组男性均高于女性,总发病率男女之比为2.83∶1;男女性发病率均随年龄的增大而升高,45岁以后发病率上升明显,≥65岁组最高。2002年起,绩溪县实施现代结核病控制策略(DOTS),县结核病专科门诊4年间共有1 368人就诊,确诊肺结核病人431人,初诊查痰率67.40%,痰检阳性268人,其中新发涂阳185人。在108例新发涂阳病人中,治疗2个月痰检阴转率达99.07%,治愈率达93.52%。结论绩溪县结核病控制实施DOTS策略取得较好的效果,新发涂阳病人发现率和治愈率均达到要求。今后仍需加大结核病归口管理的力度,加强各级综合性医疗机构的转诊工作。
Objective To study the incidence of pulmonary tuberculosis in Jixi County and provide a scientific basis for the development of control measures. Methods Epidemiological analysis of pulmonary tuberculosis cases reported in Jixi County from 1997 to 2005 was carried out to analyze the management of outpatients with tuberculosis specialist and the outcome of new smear positive patients. Results The average incidence of tuberculosis in Jixi County from 1997 to 2005 was 73.39 / 100 000, accounting for 35.08% (1 198/3 415) of the total number of legal A and B infectious diseases, and its proportion increased year by year. In tuberculosis patients The majority of them were peasants, accounting for 72.61% of the total. Men of all age groups were higher than females, with a total incidence rate of 2.83:1. The incidence of males and females increased with age, and after 45 years of age The incidence increased significantly, the highest 65-year-old group. Since 2002, a total of 1,368 TB patients have been diagnosed during the four-year outpatient TB clinic implementation in Jixi County. The number of newly diagnosed sputum samples was 67.40% and 268 were positive sputum tests. Among them, 185 positive people. In 108 cases of smear positive smear, the sputum test negative conversion rate was 99.07% and the cure rate was 93.52% after 2 months of treatment. Conclusion The implementation of DOTS strategy for tuberculosis control in Jixi County has achieved good results. The detection rate and cure rate of new smear-positive patients have met the requirements. In the future, efforts should be made to intensify the centralized management of tuberculosis and step up the referral work of comprehensive medical institutions at all levels.