摘要
目的分析麻风畸残预防(Prevention of Disability,POD)干预措施对麻风畸残预防的远期效果,为制定麻风病畸残防治策略及干预措施提供科学依据。方法采用回顾性队列研究的方法对贵州省兴义市参加过2000—2003年POD项目的242例麻风受累者进行流行病学调查,并通过比较患者确诊时、POD基线调查和2014年调查这3个时期的畸残情况来了解POD项目的远期效果。结果 242例患者在确诊时1级和2级畸残分别占76.86%(186/242)和12.81%(31/242);在POD项目基线调查时,1级和2级畸残患者占比变为25.62%(62/242)和63.63%(154/242),畸残不断恶化;但POD项目结束后的10年间,仅有7.02%(17/242)患者的畸残发生恶化,另有17.36%(42/242)例畸残状况好转,这与从患者确诊到POD项目开始病人畸残发生恶化相比,患者畸残情况得到改善,差异有统计学意义(P<0.05)。224例需要自我护理的患者中,有173(77.23%)例患者坚持每周2次以上自我护理,坚持自我护理的患者与未坚持自我护理患者相比,畸残情况得到改善,差异有统计学意义(P<0.05)。对52例患者实施的64项手术的满意率为48.4%,15.6%的不满意,不满意中占比最高的为复杂性足溃疡清创术手术。结论在患者治疗管理的2~3年期间帮助患者学会并养成自我护理和功能锻炼习惯,是预防患者在结束治疗管理后防止畸残恶化最有效、最简便、最经济的干预措施,防止畸残恶化的远期效果突出。
[Objective]To analyze the long-term effects of Prevention of Disability（POD） on people affected by leprosy, provide scientific basis for the development of the control strategy and intervention measures of leprosy. [Methods] By the historical cohort study, the epidemiological investigation was conducted among 242 leprosy patients who have participated in the POD program from 2000 to 2003 in Yixing City of Guizhou Province. The long-term effects of POD project was analyzed by comparing the disability status in three periods of diagnosis, POD baseline survey and 2014 investigation. [Results] The patients with Grade1 or Grade 2 disability accounted for 76.86%（186/242） and 12.81%（31/242） respectively among 242 patients when they were diagnosed. The number of Grade 1 or Grade 2 disability accounted for 25.62%（62/242） and 63.63%（154/242） at the baseline of POD program, indicating the worsening status. After 10 years of the POD project, only 7.02%（17/242） patients＇ disabilities became worse and 17.36%（42/242） patients＇ disabilities improved. The patients＇ disabilities have improved as compared with the diagnosed period and beginning of POD, and difference was statistically significant（P〈0.05）. 173（77.23%） of 224 patients who need self care persisted to do self-care activity 2 times or more per week. The patients who insisted on self-care had better status on disability than those who did not insist on self-care, and difference was statistically significant（P〈0.05）. 52 patients received64 operations, the satisfaction rate was 48.4%, and 15.6% of operations were not satisfactory. The debridement for complicated ulcers on feet accounted for the highest proportion of the non-satisfaction operations. [Conclusion] Teaching and building a habit of self-care and functional exercise for leprosy patient in 2-3 years during treatment management period is the most effective,convenient and well cost-effect intervention to prevent patient＇s disability deterioration. And it also disp
作者
赖雅芳
洪峰
杨梨丽
王永红
赵廷方
杨昌明
李进岚
LAI Ya-fang;HONG Feng;YANG Li-li;WANG Yong-hong;ZHAO Ting-fang;YANG Chang-ruing;LI Jin-lan(Schoal of Public Health, Guizhou Medical University, Guiyang Guizhou, 550004, China;AIDS, STD＆Dermatologu Institute;TB Control Institute, Guizhou Provincial Center for Disease Control and Prevention, Guiyang Guizhou, 550004, China;Leprosy Department, Xingyi Station for Skin Disease and STD Control and Prevention, Xingyi Guizhou, 562400, China;Leprosy Department, Qianxinan Provincial Center for Disease Control and Prevention, Xingyi Guizhou, 550004, China)
出处
《职业与健康》
CAS
2018年第7期909-912,共4页
Occupation and Health
基金
国家自然科学基金(81260436)
关键词
麻风病
畸残预防
自我护理
远期效果
Leprosy
Prevention of disability
Self-care
Long-term effect
