摘要
目的研究广西青少年出现新发涂阳肺结核发现延误(就诊和确诊延误)情况及对疗效的影响,分析发现延误(就诊和确诊延误)的影响因素。方法收集2010-2015年广西登记管理的10-19岁新发涂阳肺结核,对患者人口学特征、临床特点、不同延误水平指标、预后结果进行描述性分析和多因素Logistic回归分析。结果共收集到2 196例青少年新发涂阳肺结核患者,就诊延误时间中位数为36 d,确诊延误时间中位数为1 d。治愈2 122例,治愈率为96.6%。多因素分析结果显示,男性患者比女性患者就诊延误时间短,学生发生就诊延误时间较长的风险小于非学生患者。肺部有空洞患者就诊延误时间较长(OR=1.31,95%CI:1.10～1.57,P=0.002)。少数民族外地人口患者来源为转诊和追踪到位和肺部有空洞的患者发生确诊延误时间较长。治疗管理方式为全程督导和服药满6个月的患者治愈率更高。结论广西青少年新发涂阳肺结核发现延误时间低于普通人群,治愈率高于国家规划指标要求。就诊延误与患者职业、肺部空洞有关,确诊延误与民族、患者来源及肺部空洞有关。
Objective To study the length of patient delay and heahh system delay, and influence on the treatment outcomes, analyze the influencing factors of delays among adolescents with new smear positive tuberculosis （TB） in Guangxi Zhuang Autonomous Region of China. Methods New smear-positive pulmonary tuberculosis patients aged 10-19 years managed by Guangxi Zhuang Autonomous Region during the period from 2010 to 2015 were collected. Descriptive study was used to analyze the patients＇ demographic, clinical characteristics, different delay level and treatment outcome. Descriptive statistics and multivariate Logistic regression analysis were employed. Results A total of 2 196 adolescents were retrieved in the study. The median patient delay was 36 days and health system delay was 1 days, respectively. 2 122 cases were cured, the cure rate was 96. 6%. Male, students adolescents were more likely to have shorter patient delay. Had cavitation on chest (OR = 1.31,95 % CI： 1.10-1.57, P = 0. 002） were more likely to have long patient delay. Ethnic minorities, migrants, referral to the TB hospital and cavitation on chest were more likely to have long health system delay. Predictors for cure included intensive treatment supervision and drug adherence for six months. Conclusions The delay periods of adolescents TB were lower than that of the general population, the cure rate was higher than the national planning indicators requirements. Occupation and pulmonary cavity were associated with patient delays, ethnic, patients with source and pulmonary cavity were associated with health system delay.
作者
潘冬香
林玫
梁大斌
黄敏莹
苏华斌
林定文
PAN Dong-xiang;LIN Mei;LIANG Da-bin;HUANG Min-ying;SU Hua-bin;LIN Ding- wen.(Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Centre for Diseuse Prevention and Control, Nanning 530021, China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2018年第5期459-463,共5页
Chinese Journal of Disease Control & Prevention
基金
肺结核病聚集性疫情处置及管理模式的研究(Z2016435)
结核病实时网络信息管理系统开发与应用(S201559)
关键词
肺结核
就诊延误
确诊延误
治愈
Pulmonary tuberculosis
Patient delay
Health system delay
Cure
