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背景:澳大利亚维多利亚州。目的:对1991年向国家登记处报告的所有活动性结核病病人调查坐失预防良机的原因并检查与病案管理有关预防方面的情况。设计:属描述性调查。对维多利亚州已于1991年报告的231/236例的病案记录进行回顾。对所有病例的既往结核病筛检、预防性治疗、活动性结核病处置以及随访等项记录进行追索。既往筛检的定义是指既往接触者筛检、移民筛检、难民筛检以及结核病健康检查。结果:231例中13人未确诊有结核病。其余的218人中,78％在国外出生,其中约一半在来澳大利亚3年内被诊断有结核病。在218名病人中约一半(97人)可查到结核病既往筛检的某些记录表格。最常见的筛检类型是难民和移民筛检(45/218,21％)其次是结核病健康检查(25/218,12％)以及接触者筛检(15/218,7％)。在有既往筛检记录者中,70％(68/97)当时的筛检为阳性结果。其中,首次筛检确诊为活动性结核病者为5/68,确诊有结核感染者为63/68。后一组中仅5％(3/63)接受过预防性治疗。结论:维多利亚州存在着明显地坐失预防结核病良机的情况,尤其对入境时接受过筛检的国外出生者更是如此。筛检是一项有意义的做法,并在有医学适应征时应进行预防性治疗。
Background: Victoria, Australia. Purpose: To investigate the causes of ill effects and investigate the prevention of cases-related management of all active TB patients reported to the national registry in 1991. Design: a descriptive survey. A review of 231/236 medical records reported by Victoria in 1991. Recorded records of past TB screening, prophylactic treatment, active TB treatment and follow-up in all cases. The definition of past screening refers to past contacts screening, immigration screening, refugee screening and tuberculosis health checkups. Results: Thirteen of 231 patients were not diagnosed with tuberculosis. Of the remaining 218, 78% are born abroad, of whom about half are diagnosed with TB within three years of coming to Australia. About half of the 218 patients (97) have access to certain records of previous screening of tuberculosis. The most common types of screening are refugee and immigrant screening (45 / 218,21%) followed by tuberculosis health check (25 / 218,12%) and contact screening (15 / 218,7%). Of those with previous screening records, 70% (68/97) of the screening was positive at the time. Among them, 5/68 were diagnosed as active tuberculosis for the first time, and 63/68 were diagnosed as having tuberculosis. Only 5% (3/63) of the latter group received prophylactic treatment. Conclusion: There is a clear victorious state of Victorian presence for the prevention of tuberculosis, especially for foreign-born screening recipients. Screening is a meaningful exercise and should be done prophylactically when there is a medical indication.