新疆维吾尔自治区综合医疗机构痰检质控工作评价

Evaluation of the quality control of sputum examination in general hospitals of Xinjiang Uygur Autonomous Region

目的分析新疆维吾尔自治区综合医疗机构痰检质控工作情况,探讨提高痰检质量的有效措施。方法根据自治区疾病预防控制中心结核病控制中心对全区综合医疗机构的督导记录和痰涂片复检质控结果、进行综合分析和评价。结果2007年53家基层综合医疗机构,共登记可疑肺结核症状者21313例,查痰6989例发现涂阳肺结核403例,涂阳检出率5.8%。未查痰病人转至结防机构查痰5972例,发现涂阳肺结核2030例,涂阳检出率34.0%。涂阴病人转至结防机构再查痰3940例,涂阳肺结核893例,涂阳检出率22.7%。结防机构查痰29048例,涂阳9896例,涂阳检出率34.1%,与综合医疗机构比较差异有统计学意义(P<0.05)。结论加强综合医疗机构与结防机构的合作。对综合医疗机构痰涂片检查人员进行业务培训及复训,提高痰检质控质量,保证检出率,以达到提高涂阳病例发现的目的。

Objective To analyze the quality control work of sputum smear examination in general hospitals and to explore effective measures for improving TB infection source detection. Methods The monitoring reports and smear recheck quality control results of all general hospitals were analyzed and evaluated. Results In 2007, 21 313 TB suspects were registered in 53 basic-level general hospitals, among which 403 cases were smear-positive pulmonary tuberculosis, smear positive rate was 5.7 %; 6 989 smear negative and no smear results cases were referred to tuberculosis control institutes, with 5 972 cases received smear results and 2 030 cases were smear-positive pulmonary tuberculosis, smear positive rate was 33.9%. 3 940 smear-negative TB patients were referred to TB control institutes and examined sputum smear, among which 893 were smear-positive pulmonary tuberculosis cases, smear positive rate was 22.6%. 29 048 patients received their smear results in TB control institutes with 9 896 smear positive pulmonary tuberculosis cases, smear positive rate was 34.1%, there were significant differences compared with general hospitals （P〈 0.05）. Conclusions Strengthening the cooperation between general hospitals and TB control institutes, improving the training and retraining of lab technicians in general hospitals to increase quality control and detection rate in order to improve the detection of TB infection source.