某监狱157例初治涂阳肺结核患者抗痨治疗效果分析

157 cases of new smear positive pulmonary tuberculosis anti tuberculosis treatment effect analysis of a prison

目的评价监管环境下初治涂阳肺结核患者督导短程化疗(Directly Observed Treatment,Short-Course,DOTS)治疗效果。方法收集某监狱1995-2013年间确诊并完成抗痨治疗的初治涂阳肺结核患者157例,对其中未实施DOTS治疗管理的1995-2004年的68例初治涂阳肺结核患者与2005-2013年实施DOTS治疗管理的89例初治涂阳肺结核患者的管理、痰检及转归情况进行对比分析。结果对比实行DOTS治疗前后显示:初治涂阳患者治愈率由80.9%提高到98.9%,差异有统计学意义(χ2=15.367,P<0.05);且监管环境下实施DOTS治疗在规范用药率等方面均与社会结防机构差异有统计学意义(P<0.05)。结论由于监狱对DOTS策略的严格实施、经费的全额保障及监管环境所特有的强制约束性等因素,致使初治涂阳肺结核患者的治愈率有很大幅度的提高,符合DOTS项目所要求的高发现率、高治愈率目标,也为社会结防机构在如何更好实施DOTS策略方面提供了借鉴作用。

Objective Evaluation of regulatory environment of new smear positive pulmonary TB treatment effect in patients with DOTS. Methods The collection of a prison from 1995 to 2013 were identified and the completion of anti tuberculosis treatment of the initial treatment of 157 cases of smear positive pulmonary tuberculosis patients,The implementation of the 1995- 2004 DOTS of treatment management in 68 cases of new smear positive pulmonary tuberculosis patients from 2005- 2013 and the implementation of DOTS for management of 89 cases of new smear positive pulmonary tuberculosis patients with sputum examination management,and outcome were analyzed. Results The implementation of DOTS before and after treatment showed contrast： The cure rate was improved from 80. 9% to 98. 9% new smear positive patients（ χ2= 15. 367,P〈0. 05）; And there was significant statistical difference between social preventive agencies and to implement DOTS treatment on stand rise drug use rate（ P〈0. 05）. Conclusions Since compulsory restriction factors unique to a prison on the strict implementation of the DOTS strategy and budget full security,regulatory environment,resulting in new smear positive pulmonary tuberculosis patients of the cure rate has greatly improved,with high found DOTS project required rate,high cure rate target.