个案管理在特殊人群结核病患者中的应用

Application of Case-management in Tuberculosis Patients with the Special Populations

目的通过对比常规管理与个案管理在特殊人群结核病患者中的应用效果,分析个案管理的临床应用价值。方法选取2014年1月~2014年12月期间在我院初次治疗的痰菌阳性特殊人群结核病患者180例作为研究对象,随机分为实验组和对照组,对照组给予广东省结核病控制项目要求制定的常规管理,实验组在常规管理的基础上结合个案管理。结果实验组的治愈率为76.7%,肺部病灶好转率为58.9%,用药依从性为75.6%;对照组的治愈率为52.2%,肺部病灶好转率为41.1%,用药依从性为48.9%,两组患者以上指标比较差异均具有统计学意义（P〈0.05）。实验组治疗2、5、6个月后的痰菌阳性阴转率分别为52.2%、96.7%以及96.7%,对照组分别为35.6%、80.0%以及80.0%,两组比较差异均具有统计学意义（P〈0.05）。结论个案管理可以提高特殊人群结核病患者的管理质量,进一步提高临床疗效,具有一定的临床推广价值。

Objective To compare the applications effect between conventional management and case-management in tuberculosis patients with the special populations,analyzed the clinical value of case-management.Methods A total of 180 tuberculosis patients with the sputumpositive special populations who were selected during January 2014 to December 2014 in our hospital,they were primary treatment,and the rats were divided into experiment group and control group,The control group received conventional management was made based on Tuberculosis control project of Guangdong, case management combined on the basis of conventional management of experiment group. Results In the experiment group the cure rate was 76.7%,the lung lesion improvement rate was 58.9% and medication compliance was 75.6%;and the control group the cure rate was 52.2%,in the lung lesion improvement rate was 41.1% and medication compliance was 48.9%,two groups of patients above indicators differences were statistically significant（P〈0.05）.The sputum conversion rates of the experiment group after 2,5,6 months treatment were 52.2%, 96.7% and 96.7%,respectively and control group were 35.6%、80.0% and 80.0%,respectively.The difference between the two groups was statistically significant（P〈0.05）.Conclusion Case-management can improve the management quality of tuberculosis patients with the special populations, to further improve the clinical efficacy and has a certain clinical value.