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目的探讨影响瑞安市流动人口肺结核病治疗和管理的相关因素,为提高流动人口肺结核患者的治愈率和制定相应的政策提供科学依据。方法将2007-2008年于瑞安市结核门诊新诊断的304例流动人口涂阳肺结核患者作为观察组,选择同期户籍人口涂阳肺结核患者301例作为对照组,进行病例和病例对照研究。搜集患者就诊延误时间、治疗前症状、胸部影像学、痰涂片、治疗情况、治疗转归等因素数据,分析影响流动人口肺结核患者治疗和管理的因素。结果流动人口组与户籍人口组在性别上无明显差异。两组的年龄、就诊延误时间、治疗前症状、胸部影像学、痰涂片、治疗情况和治疗转归等经单因素分析,差异有统计学意义(P<0.05)。在就诊延误的影响因素方面,发现不重视是主要原因,其次是症状轻。结论本次调查发现,与户籍人口肺结核病例对比,流动人口病例中以男性青壮年患者居多,流动人口的就诊延误时间更长,临床症状更重,治疗的规范性较差,治疗的转归亦不理想,我们必须加大对流动人口肺结核患者的管理力度,提高DOTS策略的效果。
Objective To explore the related factors that affect the treatment and management of pulmonary tuberculosis among floating population in Ruian and provide a scientific basis for improving the cure rate and formulating the corresponding policies for floating population with tuberculosis. Methods A total of 304 newly diagnosed smear positive pulmonary tuberculosis patients from TB clinics in Rui’an City from 2007 to 2008 were selected as the observation group. 301 cases with smear positive pulmonary tuberculosis in the same period were selected as the control group, and case and case control studies were conducted. Collecting data on the delay of treatment, symptom before treatment, thoracic imaging, sputum smear, treatment, and treatment outcome were analyzed to analyze the factors influencing the treatment and management of tuberculosis patients in floating population. Results There were no significant differences in sex between the floating population and the household registration population. The two groups were statistically significant (P <0.05), such as the age, delay of treatment, symptom before treatment, chest radiography, sputum smear, treatment and treatment outcome after univariate analysis. In terms of the factors influencing the delay in treatment, it is found that neglect is the main reason, followed by mild symptoms. Conclusions This survey found that compared with the cases of tuberculosis registered permanent residence, the majority of male migrant patients were young, the floating population had longer delay of treatment, more severe clinical symptoms, poor standardization of treatment, and the outcome of treatment Not ideal, we must step up the management of migrant tuberculosis patients and improve the effectiveness of the DOTS strategy.