1112例肺结核诊断延误情况分析及动态观察

Analysis of Delayed Diagnosis and Serial Observations of 1112 Cases of Pulmonary Tuberculosis

本文旨在通过对肺结核诊断延误因素的分析和1982～1986年间的动态观察,发现延误诊断的症结。1112例因症就诊肺结核病人中,661例诊断延误占59.4%,其中病人延误280例占36.2%,医生延误463例占63.8%,平均延误65.5天;365例涂阳病人中,221例诊断延误占60.5%,病人延误112例占45.5%,医生延误133例占54.8%,平均延误73.8天。涂阳病人:1982～1986年病人延误逐年略有下降但无显著性(P>0.05);医生延误有逐年增加趋势,及时确诊率逐年下降。老年组的自身延误高于其他各年龄组差异有显著性。Ⅰ型肺结核医生延误率最高Ⅴ型最低。医生诊断延误的最重要因素是对查痰重视不够,对结核病疫情观念较为淡薄。最后结合文献对改善延误状况的措施进行了简要讨论。

Six hundred and sixty-one cases out of 1112 patients with pulmonary tuberculo-sis from 1982～1986 were delayed in diagnosis,the delay rate was 59.4%.averaging65.5 days delayed.The delay attributed to doctors (63.8%) was higher than thatattributed to patients (36.2%).Among the 1112 patients,365 cases were smear posi-tive,in them 221 cases (60.5%) were delayed in diagnosis,the “patient's delay” wasdecreasing for five years but with no significant difference,whereas the “doctor'sdelay” was increasing year by year.Patients in old age and primary tuberculosiswas more liable to be delayed.Finally,measures to surmount phenomena mentionedabove were briefly discussed.