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目的分析免费抗结核药物的使用情况及相关因素。方法采用回顾性现况调查方法,选择鄞州区2008年登记的肺结核病人一年内治愈和完成治疗的患者作为本次调查对象,包括抗结核药物使用种类、服药情况、复查情况、副反应等。结果调查381例患者,男性250例、女性131例;有家族史及密切接触史136例(35.70%);使用免费抗结核药物方案占总数54.07%,使用免费和自费混合抗结核药物方案占总数22.57%,使用自费抗结核药物方案占总数23.36%;使用抗结核药物产生副反应病例占总数27.56%;产生副反应病例中,坚持用免费抗结核药物方案占36.19%;用免费和自费混合抗结核药物方案占50.48%,用自费抗结核药物方案占13.33%;抗结核药物使用产生副反应肝损害为主,占44.7%。结论有65.35%的肺结核病例使用国家免费抗结核药物,享受国家对肺结核病人免费药物。发现影响免费抗结核药物使用的因素有:医院在经济利益驱动下医生对肺结核病例使用了自费抗结核药物;近几年“农保”、“医保”比例不断增大,也有一小部分病例自己要求使用自费抗结核药物;抗结核药物的副反应影响免费抗结核药物的使用。建议要生产、推广适合病人使用、质优低毒、副反应少的免费抗结核药物,并纳入到农保、医保机制中;让病人真正享受到国家对肺结核病治疗的经济补助的实惠。
Objective To analyze the use of free anti-TB drugs and related factors. Methods A retrospective survey was conducted to select patients who were cured and completed within one year of registration of TB patients in Yinzhou District in 2008. This survey included the types of anti-TB drugs used, medication status, review status and side effects. Results A total of 381 patients were surveyed, including 250 males and 131 females. A total of 136 cases (35.70%) had family history and close contact history. 54.07% of them used free anti-tuberculosis drugs, 22.57%, using anti-tuberculosis drugs at their own expense account for 23.36%; use of anti-TB drugs accounted for 27.56% of the total number of side effects; side effects occurred in cases, insist on using free anti-TB drugs accounted for 36.19%; with free and self-mixed anti- Tuberculosis drug programs accounted for 50.48%, with their own anti-TB drug program accounted for 13.33%; anti-TB drug use side effects of liver damage, accounting for 44.7%. Conclusions There are 65.35% cases of tuberculosis using the national free anti-tuberculosis drugs and enjoying the national free drug for tuberculosis patients. The factors that affect the use of free anti-TB drugs are: hospitals use self-financing anti-tuberculosis drugs for tuberculosis cases driven by economic interests; in recent years, the proportion of “health insurance” and “health insurance” has been increasing, and there is also a A small number of cases require their own use of anti-TB drugs; side effects of anti-TB drugs affect the use of free anti-TB drugs. It is recommended to produce and popularize free anti-TB drugs that are suitable for patient use, with high quality and low toxicity and few side reactions and be included in the agricultural insurance and medical insurance mechanism; so that the patients can really enjoy the economic benefits of national TB treatment.