浙江省肺结核病人发现模式和效果分析评价

The effect analysis of the tuberculosis case-finding mode in Zhejiang province

目的 充分发挥综合医院作用 ,提高肺结核病人发现率。方法 通过全面推行结核病控制策略 (DOTS) ,实行以综合医院为中心的归口转诊模式 ,明确结核病诊治机构和综合医院职责和分工 ,建立综合医院转诊制度。结果 全省传染源发现率平均已达 5 5 .7% ;新发涂阳肺结核病新登记率从 2 0 0 1年 16 .37 10万上升到 2 0 0 3年 2 5 .6 0 10万 ,增长了 5 5 .5 % ;转诊率从 2 0 0 0年 77.8%上升到 2 0 0 3年 95 .9% ,增长了 4 4.2 %。结论 全省以综合医院为中心的归口转诊制度的推行 ,有效提高了综合医院肺结核病人的转诊率和涂阳病人的发现工作 ,因此如何利用现有医疗资源 ,发挥综合性医院的作用 ,对结核病控制工作是至关重要的。

Objective To improve the tuberculosis case-finding rate through strengthening the important rules played by the general hospital on tuberculosis control work.Methods To change the traditional tuberculosis control mode and extensively implement the referring case-management system,and to assign the responsibility of the tuberculosis control institution and the general hospital.Results The detection rate for new smear positive cases already increased to 55.7%. New notification rate of smear-positive pulmonary tuberculosis cases increased from 16.37/10 5 in 2001 to 25.60/10 5 in 2003. The referred rate increased from 77.8% in 2000 to 95.9% in 2003.Conclusion The referring case-management system effectively increased the case-finding rate and the referring rate in hospital. It's a key to utilize existing medical care facicities for tuberculosis control.