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目的分析周宁县2002~2014年涂阳肺结核病人的发现和治疗转归情况,为评价实施结核病控制项目效果和防治工作的可持续性提供依据。方法对2002~2014年周宁县结核病防治相关资料进行分析。结果 2002~2014年共报告活动性肺结核病人1187例,平均年报告发病率47.40/10万,其中涂阳、新涂阳、复治涂阳、新涂阴分别为30.55/10万、26.67/10万、3.88/10万、16.85/10万(422/2 504 300),登记率均较低,但仍然完成了发现率70%以上的规划指标。2002~2005年活动性、涂阳、新涂阳登记率均呈逐年上升趋势(P<0.05或<0.01);从2006年起活动性、涂阳、新涂阳登记率均逐年下降(P均<0.01)。治疗2个月末痰菌阴转率年平均为94.64%,其中新涂阳、复治涂阳分别为95.81%、86.6%,均超过80%规划指标;13年来共治愈病人703例,涂阳、新涂阳平均治愈率为91.89%、93.41%,均达到并超过85%的规划指标。死亡10例,病死率为1.31%。结论2002~2014年周宁县结核病防治工作取得了良好的效果,DOTS策略的贯彻实施是提高涂阳肺结核病人发现率和治愈率的保证。
Objective To analyze the detection and treatment outcome of smear-positive pulmonary tuberculosis in Zhouning county from 2002 to 2014 and provide the basis for evaluating the effect of tuberculosis control project and the sustainability of prevention and cure. Methods The data of tuberculosis control in Zhouning County from 2002 to 2014 were analyzed. Results A total of 1187 active pulmonary tuberculosis cases were reported from 2002 to 2014, with an average annual incidence of 47.40 / 100,000. Among them, smear positive, new smear positive, retreating positive smear and new smear were 30.55 / 100,000 and 26.67 / 10 respectively 10,000, 3.88 / 100,000, 16.85 / 100,000 (422/2 504 300). The registration rates were both lower, but still completed the planning target with a detection rate of over 70%. Registration rates of smear positive smear and new smear positive increased year by year (P <0.05 or <0.01) from 2002 to 2005; enrollment rates of smear positive smear and new smear decreased year by year from 2006 (P <0.01). The average annual sputum negative conversion rate at the end of 2 months of treatment was 94.64%, of which 95.81% and 86.6% were new smear positive and retreated smear, respectively, all of which exceeded 80% of the planning targets. In the past 13 years, a total of 703 patients were cured, The average cure rate of new smear positive was 91.89% and 93.41%, both meeting and exceeding 85% of planning targets. 10 cases died, the case fatality rate was 1.31%. Conclusion The prevention and treatment of tuberculosis in Zhouning County from 2002 to 2014 has achieved good results. The implementation of DOTS strategy is the guarantee to improve the detection rate and cure rate of smear positive pulmonary tuberculosis patients.