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目的分析村医推荐疑似肺结核患者,对提高疑似肺结核患者就诊率和新涂阳肺结核患者发现率的效果。方法在30个县由经过培训的乡村医生对肺结核可疑症状者进行摸底,推荐到县结防机构或附近的乡镇、综合医院查痰点进行免费查痰,并给予每位确诊的活动性肺结核患者交通补助费8元,每确诊1例涂阳肺结核患者,奖励推荐村医24元。所有数据处理均采用SAS 8.1软件统计工作分析。结果一年项目期,疑似肺结核患者就诊率由1.4‰提高到1.8‰,村医推荐疑似肺结核患者就诊率由0.2‰提高到0.6‰,新涂阳登记率由项目实施前的36.2/10万,提高到49.9/10万,新涂阳患者发现率由64.6%提高到86.0%,推荐和自己就诊疑似患者中涂阳检出率分别为50.3%和45.6%,其中新涂阳患者占涂阳患者比例分别为86.3%和80.3%。结论采用村医推荐方法,能有效提高疑似肺结核患者就诊率和新涂阳患者的发现率。
Objective To analyze the effect of village doctor recommending suspected pulmonary tuberculosis patients on improving the visiting rate of suspected pulmonary tuberculosis patients and the detection rate of new smear positive pulmonary tuberculosis patients. Methods In 30 counties, trained village doctors thoroughly investigated the suspicious symptoms of tuberculosis, and recommended to the county’s prevention and control agencies or nearby towns and townships. The general hospital sputum smear was searched for sputum for free and each confirmed active pulmonary tuberculosis patient Traffic subsidy 8 yuan, each diagnosed with smear positive pulmonary tuberculosis patients, reward recommended village doctors 24 yuan. All data processing uses SAS 8.1 software statistical work analysis. Results During the one-year project period, the referral rate of suspected TB patients increased from 1.4 ‰ to 1.8 ‰. The village doctor recommended the referral rate of suspected TB patients from 0.2 ‰ to 0.6 ‰. The registration rate of new smear positives was 36.2 / 100 000 before the implementation of the project, To 49.9 per 100 000. The detection rate of new smear positive patients increased from 64.6% to 86.0%. The positive smear positive rates of patients who recommended and self-diagnosed were 50.3% and 45.6% respectively. Among them, The proportions were 86.3% and 80.3% respectively. Conclusion The recommended method of village doctors can effectively improve the detection rate of patients with suspected pulmonary tuberculosis and the new smear-positive patients.