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目的探讨家庭成员短程督导化疗对提高新发肺结核患者治疗依从性的效果。方法采用2006年1—12月密云县户籍新发患者为结核病防治所和社区卫生服务中心医务人员督导的(Ⅰ组)为对照组,2007年1—12月密云县户籍新发肺结核患者为家庭成员督导的为试验组(Ⅱ组),分别在结核病防治所、社区卫生服务中心和家庭督导员督导下实施短程督导化疗,比较2组治疗依从性和治疗效果。结果2006年共登记新发肺结核128例,2007年共登记新发肺结核133例。即:对照组(Ⅰ组)128例,试验组(Ⅱ组)133例;Ⅰ组2、5、6月末随访查痰率分别为95.3%、90.6%和85.9%,Ⅱ组2、5、6月末随访查痰率分别为97.7%、94.0%和94.7%。II组6月末随访查痰率明显高于Ⅰ组(P<0.01)。Ⅰ组和Ⅱ组规则服药率分别为93.8%和97.7%,Ⅱ组规则服药率明显高于Ⅰ组(P<0.01)。Ⅰ组和Ⅱ组的治愈率分别为88.3%和94.7%,Ⅱ组治愈率高于Ⅰ组。结论在推广全程督导化疗有困难的边远山区和贫困农村,鼓励具有一定文化程度,经过培训的结核病患者家庭成员或志愿者担任家庭督导员,督导病人按时服药及复查,可以弥补辖区结核病防治所、社区卫生服务中心医生在部分农村地区做全程督导治疗有困难,从而提高患者治疗依从性和全程督导短程化疗(DOTS)实施质量。
Objective To investigate the effect of short-range superficial chemotherapy of family members on the improvement of treatment compliance in newly-diagnosed pulmonary tuberculosis patients. Methods From January to December 2006, new cases of household registration in Miyun County were supervised by medical staff of tuberculosis prevention and control center and community health service center (group Ⅰ) as control group. From January to December 2007, new TB patients The members were supervising the experimental group (group Ⅱ), and under the supervision of the TB prevention and control center, community health service center and family supervisor respectively, short-course superficial chemotherapy was performed. The treatment compliance and the treatment effect were compared between the two groups. Results In 2006, a total of 128 new cases of tuberculosis were registered. In 2007, 133 cases of newly registered tuberculosis were registered. The control group (group Ⅰ) 128 cases, the experimental group (group Ⅱ) 133 cases; Ⅰ group 2, 5, 6 months follow-up sputum rates were 95.3%, 90.6% and 85.9%, Ⅱ group 2,5,6 Month-end follow-up sputum rates were 97.7%, 94.0% and 94.7%. The sputum rate of follow-up in group II at the end of June was significantly higher than that in group I (P <0.01). The prescription rates of group Ⅰ and group Ⅱ were 93.8% and 97.7% respectively, and those of group Ⅱ were significantly higher than those of group Ⅰ (P <0.01). The cure rates of group Ⅰ and group Ⅱ were 88.3% and 94.7% respectively. The cure rate of group Ⅱ was higher than that of group Ⅰ. Conclusion In promoting remote monitoring of chemotherapy in remote mountainous areas and poor rural areas, to encourage a family member or volunteer with a certain degree of education and training of tuberculosis patients as family supervisors to supervise patients on time medication and review, you can make up for tuberculosis prevention and control centers, Community health service center doctors in some rural areas to do full supervision and treatment of patients with difficulty, thereby improving patient compliance with treatment and full supervision of the implementation of short-wave chemotherapy (DOTS) implementation quality.