转诊模式对跨区肺结核患者疗效的影响

THE AFFECT OF REFERRAL MODE ON THE CURING EFFECT OF CROSS-AREA PATIENTS WITH PULMONARY TUBERCULOSIS

目的探讨一对一转诊干预与集体宣教后自行转诊对跨区结核病患者管治效果的影响。方法随机将跨区管理的肺结核患者按一对一宣教后转诊的结核病患者定为研究组,集体宣教后自行转诊的结核病患者定为对照组,两组除了转诊方式不同外,其余管理相同。从两组的到位(到达转入结防机构)情况﹑转归(治疗转归)情况﹑规则治疗率﹑规则查痰率和系统管理率来进行评价。结果研究组的到位、重登(重新登记)、治疗成功率分别为92.7%,37%和94%。对照组分别为73%,45%和71%,研究组明显高于对照组,具有显著性差异(p<0.01)。研究组规则治疗率﹑规则查痰率﹑系统管理率分别是84.6%、90.8%和78.5%,对照组分别是69.5%、71.2%和64.4%,两组的规则治疗率有统计学差异,(p=0.044),两组的规则查痰率有统计学差异,(p=0.005),两组的系统管理率没有统计学差异。结论实行一对一转诊干预跨区结核病人,可以提高跨区结核病人的到位率、治疗成功率、规则治疗率、规则查痰率、降低重登率。

Objective Discuss on governance effect of tuberculosis patients in other districts between one-to-one self referral and referral after intervention and collective education. Methods Cross-area management in patients with pulmonary tuberculosis by random one-to-one education for referral as a study group,collective propaganda and education on their own self referral as a control group.Beside the referral mode are different,the rest management of the two groups are the same.Compare the arrival rate,treatment outcome,regular treatment,regular sputum check and systematic management of the two groups to make an evaluation. Results In study group,the arrival re-registration,treatment success was 92.7%,37% and94%;in control group that is respectively 73%,45% and 71%,study group obvious higher than control group,there is Statistically significant difference（p0.01）.Study group regular treatment rate,regular check phlegm rate and systematic management rate respectively is 84.6%,90.8% and 78.5%,control group respectively is 69.5%,71.2% and 64.4%,between two groups the regular treatment rate has Statistically significant difference（p=0.044）,two group of regular check phlegm rate has statistics differences,p=0.005,Two-group system management rate has not statistically significant differences. Conclusion Taking one-to-one spanned TB referral intervention can improve the rate of patients＇ arrival,treatment success rates,regular treatment,regular check sputum rate,lower Re-registration rates.