2006年莱芜市感染性腹泻病人就诊及报告情况调查

Investigation on Seeking Medical Advice and Case Report of Infective Diarrhea in Laiwu City in 2006

[目的]探讨莱芜市感染性腹泻就诊规律和报告情况,为腹泻病防治资源分配和疫情监测管理提供科学依据。[方法]依据感染性腹泻诊断标准确定病例定义,随机抽取市、县、乡镇和村级医疗机构进行调查,用SPSS13.0进行统计分析。[结果]共调查感染性腹泻病例885例,就诊病例主要为婴幼儿和青壮年;157例感染性腹泻的细菌学培养检出率为31.3%,肠杆菌科检出最多,占81.4%;不同级别医疗机构感染性腹泻病人就诊比例差异有统计学意义(P<0.01);用CMR法估算痢疾漏报率为30.9%,其他感染性腹泻漏报率高达66.1%。[结论]大多数门诊医生报病意识淡薄或对感染性腹泻报告的相关规程不了解,是感染性腹泻病例大量漏报的主要原因,应加强对医疗机构的技术指导、监督检查和技术培训。在腹泻病防治、监测工作中,村卫生室和乡镇级卫生院等基层医疗机构的作用不容忽视。

[Objective]To explore the regulation of seeking medical advice and case report of infective diarrhea in Laiwu city, provide scientific basis for the distribution of materials for prevention and control of diarrhea ,supervision and management of the epidemic of diarrhea. [Methods] Investigation was conducted in randomly selected medical institutions at municipal, county, town, and village level, based on the diagnostic criteria of infective diarrhea. Analysis was carried out with SPSS13.0. [Results]885 infected diarrhea cases were investigated, most of them were infants and adolescents. The detection rate of bacteria was 31.3 % in the samples collected from 157 cases with the most of enterobacteriaceae, accounting for 81.4%. There was difference of the rate of seeking medical advice in medical institutions at different levels （ P〈0.01） The missing report rate of dysentery was 30.9% with CMR method. While the missing report rate of infective diarrhea with other types was 66.1%. [Conclusion]The main causes of missing report were not taking case report seriously ,not understanding the case report regulation on infective diarrhea. Technical guidance, supervision and training must be strengthened, because of the village and town clinics played an important role in diarrhea prevention, control and supervision.