基层医院查痰点在发现结核病传染源中的作用

The functions of hospitals in grass roots to find out infectious tuberculosis cases

目的 探索鄞州区基层医院查痰点在发现结核病传染源的作用。方法 鄞州区 1 994—2 0 0 3年新登记结核病人登记薄按菌阳新登记县以上医院、中心和镇乡卫生院报告单位进行统计分析。结果 1 0年间发现结核病人 35 74例 ,菌阳病人 1 4 5 8例 ,县以上医院发现菌阳病人 4 36例占 2 9.9%,基层医院 (中心卫生院、镇乡卫生院 )发现 1 0 2 2例 ,占 70 .1 %;1 994年到 2 0 0 3年新登记菌阳率从1 2 .6 1 / 1 0万上升到 2 7.6 3/ 1 0万。 2 0 0 0年痰涂片质控抽查 ,县以上医院痰片质控达到卫生部标准 ,但基层医院痰片总符合率和阴、阳性符合率略低于目标。结论 把痰检作为基层医院临床检查常规项目 ,使基层医院成为发现结核病传染源主要力量 ;痰检工作需领导重视 ,加强措施 ,固定人员 ,加强业务培训 ,抓痰检质控 ,保证检出率 ,达到高发现传染源的目的。

Objective In order to investigate the functions of hospitals in grass roots to find out the infectious tuberculosis cases in Yinzhou Block.Methods To analyse the numbers of bacteriological positive tuberculosis cases from the tuberculosis registration book from 1994 to 2003 and broke by the sources of different level hospitals.Results There were 3 574 tuberculosis cases reported in 10 years.Of them, 1?458 cases were bacteriological positive cases.436(29.9%) positive cases were reported from hospitals at county level or above,1?022(70.1%) were reported from hospitals in grass roots (central township hosipitals and townships hosipitals).The notification rate of smear-positive cases increased form 12.61/100?000 to 27.63/100?000 in the duration of 1994 to 2003.The sampling checking of sputum smear examination in 2000 showed that the quality of sputum examination had reached the standard set by Ministry of Health in hospitals at county level or above,while it slightly lower than the standard in grass roots.Conclusion The sputum smear examination should be one of the routine clinical examination works in grass roots hospitals.And the hospitals in grass roots has been a main strength to find out the infectious tuberculosis cases.