摘要
目的通过采取干预措施,为提高综合医院发现肺结核能力提供依据。方法采取同级别随机配对及干预前后对照研究。按不同级别医院分观察组为甲1、乙1和丙1,对照组为甲2、乙2和丙2,分别观察干预与非干预医院发现肺结核情况。结果与非干预同级相比,干预后甲1肺结核报告率、报告菌阳率和报告痰检率显著高于甲2(P=0.000,P=0.045,P=0.017),乙1肺结核报告率和报告痰检率显著高于乙2(P=0.000,P=0.024),丙1肺结核报告率和报告痰检率显著低于丙2(P=0.000,P=0.001)。干预前后的自身对照在肺结核报告率、报告菌阳率和报告痰检率3项甲1差异均无显著性(P=0.182,P=0.116,P=0.583),乙1除肺结核报告率下降外(P=0.004),其他两项差异均无显著性(P=0.909,P=0.052),丙1肺结核报告率升高(P=0.025),丙2报告痰检率升高(P=0.000)。结论干预对提高综合医院发现传染性肺结核的能力有一定影响,但应建立一套(类似丙2)完善长效的发现肺结核机制,以早期提高传染性肺结核的发现。
Objective To explore the influences of intervention on the abilities of detecting pulmonary tuberculosis cases in general hospitals. Methods We selected 6 general hospitals at 3 different levels （A,B,and C）. The intervened group included hospitals A1,B1,and C1,and the non-intervened group included hospitals A2,B2,and C2. The results after intervention were compared. Results The report rate of pulmonary tuberculosis,sputum positive rate of reported cases,and sputum check rate of reported cases were significantly higher in hospital A1 than grouping hospital A2 （P=0. 000, P=0. 045, and P=0. 017, respectively）. The report rate and sputum examination rate of reported cases were significantly higher in hospital B1 than grouping hospital B2 （P =0. 000, P = 0. 024, respectively）. The report rate and sputum examination rate of reported cases were significantly lower in hospital C1 than grouping hospital C2 （P = 0. 000, P = 0. 001, respectively）. In hospital A1, the report rate, sputum positive rate of reported cases, and sputum check rate of reported cases were not significantly different before and after intervention （P = 0. 182, P = 0. 116, and P =0. 583, respec- tively）. In hospital B1, the report rate were significantly different before and after intervention （P = O. 004） , while the sputum positive rate of reported cases and sputum check rate of reported cases were not significantly different （ P = 0. 909, P = 0. 052, respectively）. In hospital CI, the report rate was significantly higher after intervention （P = 0. 025）. In hospital C2, the sputum check rate significantly increased （ P = 0. 000）. Conelusions Intervention influences the hospitals abilities to detect pulmonary tuberculosis cases. However, more optimized and long-term intervention mechanism should be established to increase case detection rate of pulmonary tuberculosis.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2009年第4期432-437,共6页
Acta Academiae Medicinae Sinicae
基金
首都医学发展基金普及推广项目(2005-3041)~~
关键词
干预
综合医院
肺结核
发现
intervention
general hospital
pulmonary tuberculosis
detection
