利用家庭督导员提高城市人口中肺结核患者完成治疗率的研究

Study of employment of family supervisor to heighten the treatment completion rate of pulmonary tuberculosis patients in city

目的探索影响石家庄市区结核患者治疗管理的因素,为国内大中城市肺结核患者管理提供可靠依据。方法采用家庭督导和医务人员督导（DOT）两种方法,对石家庄市2009-2010年登记的市内五区活动性初治肺结核患者服药管理效果做对照研究,同时,将整体效果与2007年同地区的单一DOT管理方式曾统计并发表的数据对比,检验实施效果。结果 2009-2010年登记的市内五区活动性肺结核患者的初治涂阳治愈率为92.0%,初治涂阴患者完成治疗率为96.2%,总体初治活动性肺结核（涂阳＋涂阴）患者完成治疗率为95.5%。各项指标均远高于2007年单一DOT管理方式的效果,并且家庭督导与DOT服药效果相同。结论单一的DOT服药已不能适应当前城市肺结核病患者管理的需要,家庭督导已成为城市肺结核病患者的必要管理方式。

Objective To explore the influence factors on management of pulmonary tuberculosis（P.tb） patients in Shiji azhuang City,in order to provide some reference measures for management of P.tb patients in domestic large and mediumsized cities.Methods Two management ways which were the family member monitor and the directly observed treatment（DOT） under the medical staff were taken from 2009 to 2010,then its effect for managing initial activity P.tb patients in urban districts was evaluated,and the management effect for only using DOT in the same area in 2007 was compared.Results The cure rate of initial smear postive P.tb was 92.0%,the treatment completion rate of initial smear negative P.tb was 96.2%,the total treatment completion rate of the initial activity P.tb was 95.5% from 2009 to 2010.Its effects were higher than the single DOT in 2007,and the effect of the family supervision was the same as that of the DOT.Conclusion The single way of DOT under medical personnel is unfit the needs of management of P.tb patients in city,and the pattern of family supervision becomes the essential complement.