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目的分析邢台市综合医院和结核病防治机构(简称“医防”)合作对肺结核患者发现的贡献水平,评价该策略的有效性。方法利用《中国疾病预防控制信息系统》结核病专报系统,对邢台市综合医院等非结核病防治机构(简称“非结防机构”)肺结核报告水平及其发现的肺结核转诊及到位水平和到位后确诊为肺结核情况进行统计和分析。结果2009-2013年,全市非结防机构网络报告肺结核患者5 210例,年平均报告率为15.37/10万,报告率呈下降趋势;转诊到位率和追踪到位率均呈上升趋势,总体到位率呈上升趋势,由2009年的84.14%增加到2013年的89.98%;在非结防机构网络报告的肺结核/疑似肺结核患者中,到达结防机构并被重新诊断为活动性肺结核患者数比较稳定,年均检出率为70.11%,呈缓慢下降趋势,其中,诊断为涂阳肺结核及涂阳检出率均呈明显下降趋势,排除肺结核数比较稳定,排除率呈缓慢上升趋势;非结防机构网报的肺结核到位诊断为肺结核患者为2 989例,贡献率为17.53%,呈下降趋势,由2009年20.24%下降到2013年17.50%;涂阳肺结核患者贡献率为18.57%,呈下降趋势;由2009年20.55%下降到2013年19.71%。结论医防合作对提高全市肺结核患者发现水平起到了一定作用,进一步规范非结防机构肺结核/疑似肺结核患者诊断、报告及转诊标准和加大对转诊未到位患者的追踪力度等措施是提高肺结核发现率的关键。
Objective To analyze the contribution of the cooperation between Xingtai City General Hospital and Tuberculosis Prevention and Control Institution (referred to as “medical prevention”) to the discovery of pulmonary tuberculosis patients and to evaluate the effectiveness of this strategy. Methods The reporting system of tuberculosis in non-tuberculosis prevention and control institutions (such as Xingtai General Hospital) (referred to as “non-end-to-end prevention and control institutions”) and the tuberculosis referral and the level of tuberculosis found in the hospital were analyzed using “China Disease Prevention and Control Information System” After the diagnosis of tuberculosis in place for statistics and analysis. Results From 2009 to 2013, 5 210 cases of TB patients were reported by the network of non-TB prevention and cure institutions in the city, with an annual average report rate of 15.37 / 100000, the report rate showed a downward trend; the referral rate and follow-up rate both showed an upward trend, The rate showed an upward trend from 84.14% in 2009 to 89.98% in 2013. Of the patients with TB / suspected pulmonary TB reported by the network of non-TB prevention and control agencies, the number of patients who reached the TB prevention and treatment department and were re-diagnosed as having active tuberculosis was relatively stable , With an average annual detection rate of 70.11%, showing a slow downward trend, in which the diagnosis of smear-positive pulmonary tuberculosis and smear positive rate showed a significant downward trend, the number of pulmonary tuberculosis was excluded, the exclusion rate showed a slow upward trend; non-junctional The number of TB cases diagnosed by the agency network was 2 989 cases, accounting for 17.53% of all TB cases, showing a decreasing trend from 20.24% in 2009 to 17.50% in 2013. The contribution rate of smear-positive pulmonary tuberculosis patients was 18.57%, showing a decreasing trend ; From 20.55% in 2009 to 19.71% in 2013. Conclusion The medical cooperation has played a certain role in improving the level of TB patients in the city. It is necessary to further standardize the diagnosis, reporting and referral criteria for non-TB TB / TB cases and increase follow-up of patients who are not referred The key to the detection rate of tuberculosis.