摘要
目的评价甘肃省平凉市乡(镇)卫生院耐药肺结核病病人的管理现状;了解目前该地区耐药肺结核病病人管理工作中存在的问题。方法以查阅资料、调查问卷、电话或入户面对面访谈的方式开展调查。结果43例确诊的耐药肺结核病病人中,1例常住外地、实际管理42例,耐药肺结核病病人管理率97.67%;管理的42例病人死亡1例、失访3例,本次调查访视到38例,总体规则服药率78.94%,肺结核病病人健康管理服务工作纳入基本公共卫生项目前后病人规则服药率差异无统计学意义(χ^2=1.293,Ρ>0.05);38例病人中,随访合格病人24例、不合格14例,总体随访合格率63.15%,肺结核病病人健康管理服务工作纳入基本公共卫生项目后病人随访合格率明显高于纳入前(χ^2=20.761,Ρ<0.001);38例病人中52.63%为初中及以下学历,78.94%是农村病例,28.95%有断药情况,其中超过一半(54.54%)的断药病人因症状消失自行停药;乡(镇)卫生院工作人员肺结核病防治知识知晓率88.24%,所有调查的乡(镇)卫生院工作人员均为兼职。结论平凉市耐药肺结核病病人纳入管理情况不理想,病人规则服药率和随访合格率均未达到要求,但结核病病人健康管理工作纳入基本公共卫生服务项目后,随访工作达到要求;农村人口、低学历的耐药肺结核病病人是管理的难点,且基层医疗机构缺乏肺结核病管理的专职人员。
Objective To evaluate the management status of patients with drug-resistant tuberculosis in the health center of township(town)in Pingliang city,and understand the problems existing in the management of drug-resistant tuberculosis patients.Methods The survey was conducted by looking up data,questionnaires,telephone or face-to-face interviews with patients.Results Out of the 43 patients confirmed with drug-resistant tuberculosis,1 patient permanently resided in other place,42 patients were actually managed,with the management rate of drug-resistant tuberculosis patients of 97.67%.There was 1 patient died and 3 patients lost follow-up among the 42 managed patients.Totally 38 patients were visited in the survey,with the rate of regular medication of 78.94%,and there was no statistical difference(χ^2=1.293,Ρ>0.05)in the rates of regular medication before and after the health management and service included in the project of basic public health.The follow-up of 24 patients were qualified and 14 patients were unqualified,with qualified rate of follow-up visit of 63.15%,that was significantly higher after the health management and service included in the project of basic public health than before the enrollment(χ^2=20.761,Ρ<0.001).Out of the 38 patients with drug-resistant pulmonary tuberculosis,52.63%of the patients had the education background below junior high school,78.94%of the patients came from rural area,and 28.95%stopped medication,including more than half of them(54.54%)stopped medication due to their symptoms disappeared.The awareness rate of pulmonary tuberculosis of the staff in the health centers of township(town)was 88.24%.All the staff surveyed completed the work in part-time.Conclusions The management of drug-resistant tuberculosis patients is not ideal in Pingliang city.The rate of regular medication and the qualified rate of follow-up of the patients don’t reach the requirements.After the health management of tuberculosis patients is included in the project of basic public health and service,the follow-up work meets the requirements.It is difficult to manage the patients from rural area with low educational background,and the full-time workers in the management of tuberculosis patient are lack in the basic medical institutions.
作者
姬新芬
姚春丽
郭戴青
马晓燕
JI Xin-fen;YAO Chun-li;GUO Dai-qing;MA Xiao-yan(Pingliang Municipal Center for Disease Control and Prevention,Pingliang,Gansu 744000,China)
出处
《疾病预防控制通报》
2020年第3期74-77,共4页
Bulletin of Disease Control & Prevention(China)
关键词
耐药肺结核病
随访
管理质量
Drug-resistant tuberculosis
Follow-up visit
Management quality
