广东省活动性涂阴肺结核病例登记近况分析

Analysis on Registration of Active Smear-negative Pulmonary Tuberculosis Cases in Guangdong Province

目的分析广东省涂阴肺结核登记近况，为活动性涂阴肺结核的治疗和管理提供参考。方法对2002～2006年度《广东省结核病控制项目季报表》中病人发现任务完成情况和病人发现来源情况登记资料进行汇总分析。结果近五年间，广东省涂阴登记率增长14．08％，尤其是2005、2006两年，增长速度分别为2002年的54．08％和102．43％。登记的涂阴肺结核病例来源中，转诊／就诊比值在0．89～1．21之间波动，涂阴／涂阳比值从2002年的0．39逐年增加至2006年的0．68，尤以2005、2006两年增幅明显。各市五年来涂阴登记率（1／10万）绝对增长量也从-0．86～47．01不等。涂阴免费政策实施后的2006年，各市登记涂阴病人的转诊／就诊比值相差悬殊（0．21～9．42），各市登记病人中，涂阴／涂阳比值悬殊（0．33～2．27）。结论涂阴免费政策的实施加速了广东省涂阴登记率增长。加强归口管理，促进结防机构和综合医疗机构的共同参与和合作，是涂阴肺结核免费政策有效实施的基础。目前全省各市的涂阴肺结核病人登记发展不平衡，原因可能部分在于各市涂阴肺结核诊断水平、医疗机构与结防机构合作水平的不同．

Objective To analyze the registration of active smear-negative pulmonary tuberculosis cases during past five years in Guangdong province. Methods Collect and analyze the data of case finding and case resources from the quarter reports of anti-tuberculosis project of Guangdong province in the past 5 years. Results Registration rate of smear negative cases increased by 14.08% during the past 5 years, compared to 2002, significant speed of increase took place in 2005 （54.08%） and 2006 （102.43%）. Referral /visit in negative cases waved between 0.89- 1.21. negative/positive increased from 0.39 to 0.68 year-by year also with fast speed in 2005 and 2006. Great difference exist among the absolute increment of negative registration rate （-0.86-47.01） of 21 cities during 5 years. As for referral/visit（0.21-9.42） in negative cases and negative/positive（0.33-2.27） in registed cases, great disparity exist among cities. Conclusion The policy of free of charge for smear negative cases enhance the increment of smear negative cases＇s registration rate. The basement of success of policy of free of charge for smear negative cases lies in the improvement of referral management and the cooperation between general hospital and tuberculosis control agencies. The different levels on diagnosis of smear negative cases and collaboration between general hospital and tuberculosis agencies might partly explain the imbalance in smear negative cases registration among the 21 cities.