上海市嘉定区梅毒诊疗随访干预效果评价

Evaluation of Intervention Efficacy of Syphilis Diagnosis, Treat and Follow-up in Jiading District of Shanghai

目的了解当前医疗单位梅毒诊疗与随访情况,为今后梅毒防治提供科学依据。方法将上海市嘉定区5家医疗机构确诊的患者设为干预组和对照组,干预组实施院内转诊制度和首诊医生负责制,向梅毒患者提供健康教育与咨询服务等干预措施;对照组未采取干预措施。对期间确诊的梅毒患者干预组253例、对照组206例的诊疗与随访情况进行调查分析。结果梅毒的诊断、报告和治疗两组无显著性差异;梅毒诊断科室:干预组:性病门诊占87.7%,对照组:性病门诊占51.0%,两组有显著性差异;咨询服务率:干预组99.6%,对照组39.8%,干预组明显大于对照组,二者有显著性差异(χ2=204.8,P<0.01);治疗后随访率:治疗后3个月、6个月、9个月及12个月随访率干预组比对照组分别高出31.3%、24.6%、16.4%和11.3%。经统计学检验,二者有显著性意义(P均<0.01)。结论落实院内转诊制度与首诊医生负责制,加强对梅毒患者的健康教育与咨询服务是提高梅毒患者治疗后随访率的有效方法。

OBJECTIVE To learn about syphilis diagnosis, treat and follow -up of medical institutions in Jiading District, providing scientific basis of syphilis prevention and control. METHODS 5 medical institutions were divided into the intervention group and control group, for the intervention group hospital referral system and first doctor in charge were given, providing health education and counseling for patients with syphilis, for control group no interventions were given. The data about 253 syphilis cases of intervention group and 206 syphilis cases of control group were selected and analyzed. RESULTS There was no significance in syphilis diagnosis, report, and treat between two groups. Patients from STD clinic accounted for 87.7% in intervention group, and 51.0% in control group, significance were seen between two groups. 99.6% of patients were provided with counseling service in intervention group, and only 39.8% in control group, significance were seen between two groups. The follow-up rate of 3-month, 6-month,9-month, and 12month of intervention group were higher than that of control group, respectively for 31.3%, 24.6%, 16.4% and 11.3%, and there was significance between two groups. CONCLUSION Carrying out the hospital referral system and first doctor in charge, strengthening health education and consulting services for patients with syphilis are effective measures of improving follow-up rate of patients with syphilis.