摘要
目的 探索有效的农村肺结核病防治管理新模式,为农村社区肺结核病防治策略的制定提供科学依据.方法 于总人口为67.9万人的广西兴业县,在县级结核病防治机构肺结核诊疗服务可及性差的农村乡镇中,选择人口数合计为152 518人的交通不便的4个乡镇作为实验组,开展以乡镇卫生院为诊疗管理中心、按社区服务可及性设服务点、聘请家庭督导员协助督导的农村肺结核病防治管理新模式的项目研究,项目基线及终期肺结核病例数分别为44例和117例;同时在该县选择条件类似、人口数合计为133 303人的大平山镇、龙安乡和高峰镇作为对照组.对照组开展现行国家结核病防治规划规定的县级结核病诊疗管理模式,基线及终期肺结核病例数分别为56例和110例.采用双向比较方法从肺结核患者发现情况、患者治疗转归情况和结核病控制工作管理情况等方面评价新模式的效果.采用SPSS 13.0统计软件进行统计分析,计数资料的组间比较采用x2检验.结果 经过2年的项目实施,项目实施前后实验组肺结核患者涂阳新登记率从16.39/10万（25/152 518）提高到51.14/10万（78/152 518）（x2=27.281,P〈0.01）;初治涂阳患者治愈率从71.4%（15/21）提高到91.1%（51/56）（x2=4.812,P〈0.05）;初治涂阴患者完成疗程率从23.5%（4/17）提高到71.4%（15/21）（x2=8.622,P〈0.01）;初治涂阳患者丢失率从23.8%（5/21）下降为0.0%（0/56）（x2=10.608,P〈0.01）;初治涂阴患者丢失率从64.7%（11/17）下降为4.8%（1/21）（x2=15.624,P〈0.01）.项目终期,实验组的初治涂阳患者治愈率[91.1%（51/56）]高于对照组的治愈率[72.0%（36/50）]（x2=6.531,P〈0.05）,而初治涂阳病例丢失率[0.0%（0/56）]低于对照组[16.0%（8/50）]（x2=7.534,P〈0.01）;项目实施期间实验组患者的按时服药率[91.5%（107/117）]、按时领药率[100.0%（117/117）]、按时复查痰率[83.6%（98/117）]均�
Objective To explore the effect of new model for tuberculosis （TB） control and management, and provide a scientific basis and justification for making TB control strategies in rural communities. Methods Among those townships with low TB service accessibility by the county TB control institute in Guangxi Xingye county （population of 679 thousands）, four townships with total population of 152 518 and inconvenient transportation, were selected as the experimental group to conduct a new model research project. Based on the accessibility for community services, setting diagnosis and treatment management centers in township hospitals, employing family treatment supporters to supervise the treatment process. The TB cases of the base-line and the project expiration of the experimental group were 44 and 117. Meanwhile,three townships including Dapingshan, Longan and Gaofeng in the county with the similar condition and total population of 133 303 were selected as the control group. The control group conducted the provisions of national TB control program in the county TB clinic management. The TB cases of the base-line and the project expiration of the control group were 56 and 110. By double-direction comparison method ,the effect of the new model was evaluated through TB patients detection, treatment outcomes and TB control management data. SPSS 13.0 statistical software was adopted and Chi-square test was used for analyzing technical data. Results After two-year project research implementation, in the experimental group the detection rate of new smear-positive TB patients increased from 16. 39/100 000 （25/152 518） to 51.14/100 000 （78/152 518） （x2 = 27.281, P 〈 0. 01）, the cure rate of new smear-positive cases increased from 71.4% （15/21） to 91.1% （51/56） （x2 = 4. 812, P 〈 0. 05）, and the completing treatment rate in newly diagnosed smear-negative cases improved from 23.5% （4/17） to 71.4% （15/21） （x2 = 8. 622, P 〈0. 01） ;the loss rate of newly diagnosed smear-positive ca
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2011年第1期30-35,共6页
Chinese Journal of Preventive Medicine
基金
基金项目：英国国际发展部传染病控制项目结核病子项目（HD206-RG.NUFF460859）
关键词
结核
肺
疾病管理
农村卫生
评价研究
Tuberculosis, pulmonary
Disease management
Rural health
Evaluation studies
