19所乡镇卫生院喹喏酮类药物的使用及其对肺结核诊断延误的影响

Study on quinolones-use in 19 township health centers and its influence on the delay in diagnosis of tuberculosis

目的了解乡镇卫生院因呼吸道疾病住院的患者喹喏酮类药物的使用,以及其使用对肺结核患者诊断的影响;为将来的结核病防治工作提供可行性建议。方法从开展耐多药防治工作的一个市和未开展耐多药防治工作的2个市所辖的所有县区中,分别随机抽取一个乡镇,调查2013年上半年所有因呼吸道疾病住院患者的抗生素使用情况,及结核诊断情况。结果调查的759例患者中,左氧氟沙星的使用率为38.47%,开展耐药工作的市和未开展耐药工作的市,左氧氟沙星的使用率无显著性差异(P>0.05)。最终确诊的23例肺结核患者,其诊断延误时间的四分位数间距为18.05 d,住院期间使用头孢和使用左氧抗炎的患者诊断延误时间无统计学差异(P>0.05)。结论应加强乡镇卫生院喹喏酮类药物规范使用的管理,避免耐药结核病的产生。

Objective To understand quinolones-use on patients hospitalized with respiratory diseases in township hospitals and its influence on tuberculosis diagnosis,and provide feasible suggestions for tuberculosis prevention and treatment.Methods One city carrying out the multi-drug resistance tuberculosis（MDR-TB） project and two cities not carrying out the MDR-TB project were randomly selected.Among all the counties under the three cities,one township was selected from each city.The usage of antibiotics and diagnosis of tuberculosis of all the patients hospitalized with respiratory diseases in the first half of 2013 were investigated.Results Among the 759 cases,the usage rate of levofloxacin was 38.47%,and there was no significant rate difference between the MDR-TB city and non-MDR-TB city（P〉0.05）.For the 23 pulmonary tuberculosis cases,the quartile interval of delayed diagnosis time was 18.05 days with no significant difference between the cases medicated with cephalosporin and cases with levofloxacin（P 0.05）.Conclusion In order to prevent the occurrence of MDR-TB,the management of quinolones-use in township hospitals should be strengthened.