福建省耐多药结核病治疗与管理模式的初步研究

Primary study on the mode of treatment and management of MDR-TB in Fujian Province

目的探讨适合福建省控制耐多药结核病(MDR-TB)的治疗与管理模式。方法多渠道融资保障耐多药结核病工作的开展。卫生行政部门负责定点医院和结防机构在MDR-TB患者发现、治疗、转诊和追踪工作中的协调与管理,监督工作的落实。结果从项目启动到2010年8月31日,确诊的MDR-TB患者为41例,其中流动人口MDR-TB患者37例,占90.2%。纳入治疗的MDR-TB患者为30例,其中4例出现不良反应,不良反应发生率为13.33%。治疗满6个月的8例MDR-TB患者中,痰涂片阴性7例,6个月末转阴率为87.5%;痰培养阴性4例,6个月末转阴率为50%。病例追踪到位率为100%。结论多渠道融资为福建省耐多药结核病治疗与管理提供经费的保障。医防合作是福建省耐多药结核病治疗与管理模式的核心,为福建省耐多药结核病控制工作奠定良好的基础。

Objective To explore the mode of treatment and management of MDR-TB in Fujian province.Methods Multiple financing supported the mode of treatment and management of MDR-TB in Fujian province including detection,treatment,referral and follow-up of MDR-TB.Results Since the implementation of the mode 41 MDR-TB cases were confirmed including 37 floating population MDR-TB cases（90.2%）.Thirty cases were treated amd adverse reactions occuured to 4 cases（13.33%）.Eight cases were treated for six months,seven of them were smear-negative with a smear negative conversion rate of 87.5%;and 4 of which were culture-negative,the culture negative conversion rate of 50%.The follow-up rate was 100%.Conclusion Multiple channel raising fund ensured the implementation of mode of management and treatment of MDR-TB.Cooperation between hospitals and TB control institutions are key for treatment and management of MDR-TB.