深圳市宝安区肺结核病人发现工作评价

Evaluation on tuberculosis case detection work of Bao'an district of Shenzhen

目的评价深圳市宝安区结核病人发现工作,探讨病人发现过程中存在的薄弱环节,进一步完善病人发现机制。方法收集宝安区2007—2009年结核病网络直报、肺结核就诊追踪登记资料,抽查综合医院X线胸片诊断、报病、转诊、住院肺结核病人抗结核药品合理使用,以及药品零售店销售抗结核药品情况,并对结果进行分析。结果宝安区2007—2009年新发涂阳病人的发现率分别为80.7%、100.9%、97.8%;88.3%的患者由辖区综合医院转诊;在疑似肺结核病人未到位的原因中,地址不详占的比例为59.3%,36.7%,12.1%。抽查结果显示,全区各公立医院可疑肺结核患者转诊率达到100%,住院肺结核病人均未出现出院带药情况。在抽查的5家药品零售店中,有3家销售抗结核药品。结论深圳市宝安区综合医院对疑似肺结核病人的报告和转诊工作质量有所提高,无截留病人。全区肺结核患者发现较高。但短期流动人口病人的流失及药品零售店抗结核药物的监管是病人发现过程中的薄弱环节。

Objective To evaluate the tuberculosis（TB） case detection work of Bao＇an district of Shenzhen and explore the weakness in order to further improve the case detection mechanism.Method Data from internet based TB reporting system,TB registers was collected from 2007 to 2009.General hospitals were sampled to check the X-ray diagnosis,TB reporting,referral and tracking information,the usage of anti-TB drugs by inpatients.The situation of anti-TB drugs in drug retailers was also investigated and analyzed.Result From 2007 to 2009,new smear positive case detection rates of Bao＇an district were 80.7%,100.9% and 97.8% respectively.88.3% of patients were referred by the general hospitals.Among the TB suspects not in place after referral,in these 3 years,59.3%,36.7% and 12.1% were due to unknown address respectively.The sample showed that,the TB suspects＇ referral rate reached 100% in every public hospital.No inpatient took drugs from hospitals after discharging.In the five sampled retail drug stores,three of them sold anti-TB drugs.Conclusion The working quality of reporting and referral of TB suspects in general hospitals of Bao＇an District has improved.The case detection rate is in a relatively high level.However,the loss of patients of floating population and lack of monitoring of anti-TB drug retailers is the weakness part in the process of TB case detection.