浙江省乙型病毒性肝炎诊断符合率调查

Investigation in Diagnosis coincidence rate of viral hepatitis B in Zhejiang povince

目的:了解浙江省县以上各级医疗单位的乙型病毒性肝炎(以下简称乙肝)的诊断符合情况,修正全省乙肝报告发病率。方法:分层抽取27家医院,按国家诊断标准对作疫情报告的661例乙肝病例的化验结果进行复核。结果:符合急性乙肝诊断的217例,符合率为32.83%;符合乙肝诊断的为509例,符合率为77.00%;急性乙肝、乙肝诊断符合率均以省级医院最高,市级医院次之,县级医院最低。导致不符合诊断标准的最重要原因是未检急慢性感染标志物(抗-HB c IgM),有79.21%;其次是肝功能(ALT)未检或不符,有33.50%;血清学未检或不符的有13.30%。结论:急性乙肝的诊断符合率过低,并提出了改进措施。

Objective To learn the diagnostic coincidence rate of viral hepatitis B of prefectural and above prefectural medical institution in Zhejiang province. Then to adjust the morbidity of viral hepatitis B in Zhejiang province. Methods Twenty-seven hospitals were hierarchical sampled and investigated. The experimental results of 661 viral hepatitis B cases were checked according to the national diagnosis standard. Results 217 cases and 509 cases were respectively consistent with the national diagnosis standard of acute viral hepatitis B and viral hepatitis B. The diagnosis coincidence rates were 32. 83% and 77. 00% respectively. Provincial hospital had the highest coincidence rate of acute viral hepatitis B and viral hepatitis B. Then the civic hospital had the secondary high rate and prefectural hospital had the lowest rate. The most important reason causing the disaccord was that did not detecting the infection indication and the proportion was 79.21%. Then the proportion of not detecting ALT and not detecting serology were 33.50% and 13.30% respectively. Conclusion Diagnosis coincidence rate of acute viral hepatitis B is too low and improvement measures are raised ing this paper.