肺结核病延误诊断原因分析及对策

ANALYSIS ON CAUSES OF DELAYED DIAGNOSIS OF PULMONARY TUBERCULOSIS AND THE COUNTER-MEASURES

[目的]分析石家庄市区肺结核病人的归口管理情况及肺结核病人延误诊断的原因。[方法]对2004年石家庄市区确诊230例肺结核病人发病、就诊和治疗过程情况进行了统计。[结果]230例病人中有72例误诊为上呼吸道感染、43例误诊为肺炎、15例误诊为肺癌、30例误诊为陈旧性肺结核、70例诊为活动型肺结核。就诊延迟98例、确诊延迟82例、发现延迟50例。[结论]肺结核病的控制不仅要有一支专业的防痨队伍,还要有政府支持、各部门的联合与协作,发现可疑肺结核病人要及时进行转诊、实行归口管理,只有这样才能使我国的肺结核病人发病率下降。

[Objective] To analyze the status of convergence case-management and the causes of delayed diagnosis of pulmonary tuberculosis patients. [ Methods] A total of 230 patients with final diagnosis of pulmonary tuberculosis in Shijiazhuang in 204 were observed. The condition of their onset, consulting a doctor and cure were recorded and analyzed. [ Resuits] Of the 230 patients, 72 cases was misdiagnosed as upper respiratory tract infection, 43 cases were misdiagnosed as pneumonia, 15 cases were diagnosed as lung cancer, 30 cases were misdiagnosed as obsolete pulmonary tuberculosis, and 70 cases were misdiagnosed as active pulmonary tuberculosis. And there were 98 cases of delayed visit, 82 cases of delayed diagnosis, and 50 cases of delayed discovery. [Conclusions] The control of pulmonary tuberculosis not only needs a professional team of medical staff, but also the support of government and the cooperation of various departments ; in addition, tiruely transfer treatment and convergence case-management for suspicious pulmonary tuberculosis patients should be implementcd and improved. It is only in this way that reducing the incidence rate of pulmonary tuberculosis in China can be realized.