山西省运城市农村寄宿制学校结核病筛查结果分析

Analysis on tuberculosis screening in rural boarding schools of Yuncheng City,Shanxi Province

目的了解运城市农村寄宿制学校结核杆菌感染和患病情况,为学校开展结核病防治工作提供科学依据。方法对运城市336所农村寄宿制学校采取整群抽样调查,对118 852人采取结核菌素试验进行调查,其中学生113 537人,教职工5315人,15岁以上学生和教职工全部拍胸片等方式进行筛查。结果 PPD试验阳性人数4829人,阳性率从高到低依次为教职工、高中、小学、初中,差异有统计学意义(χ2=3.51,P<0.01);强阳性人数3339人,强阳性率从高到低依次为教职工、高中、初中、小学,差异有统计学意义(χ2=7.14,P<0.01)。对18 818名15岁以下有肺结核可疑症状者或PPD结果强阳性者以及15岁以上所有学生、教职工拍摄胸部X线,胸片异常患者26例。对26例胸片异常患者和199例疑似症状者进一步痰涂片检查,确诊活动性肺结核患者26例,其中涂阳肺结核患者4例,涂阴肺结核患者10例,结核性胸膜炎10例,肺门淋巴结核2例。结论农村寄宿制学校结核病防控工作依然严峻,各地应加大学校结核病防控力度,提高学校教职工及学生结核病防治知识知晓率,提高学校人群防病意识,控制学校结核病疫情的发生。

Objective To study the infection and prevalence of tuberculosis（ TB） in rural boarding schools of Yuncheng City,and provide scientific basis for TB prevention and control in the rural boarding schools. Methods All 336 rural boarding schools in Yuncheng City were enrolled and a cluster sampling method was used. 118 852 persons were tested by purified protein derivative of tuberculin（ PPD）,including 113 537 students and 5315 faculty members. Students aged above 15 years old and all faculty members were determined by chest X-ray inspection. Results 4829 persons were positive to PPD test,the positive rates from highest to lowest were faculty,high school students,junior high school students,elementary school students,respectively. The difference was statistically significant（ χ^2= 3. 51,P〈0. 01）. 3339 persons were strong positive to PPD test,the strong positive rates from highest to lowest were faculty,high school students,junior high school students,elementary school students respectively. The difference was statistically significant（ χ^2= 7. 14,P〈0. 01）. Among 18 818 persons including students aged under 15 years old with strongly positive PPD test or suspected symptoms,students aged above 15 years and faculty,chest X-ray examination were carried out,26 persons were chest X-ray abnormalities. Among 26 persons with chest X-ray abnormalities and 199 persons with suspected symptoms,sputum smears detection was carried out. Then,26 cases were diagnosed as active pulmonary tuberculosis,including 4 cases of smear positive pulmonary tuberculosis,10 cases of smear negative pulmonary tuberculosis,10 cases of tuberculous pleurisy,and 2 cases of hilar tuberculous lymphadenitis. Conclusion TB prevention and control were still severe in rural boarding schools,TB prevention and control should be strengthened in all schools,implementation of TB screening and normalization should be supervised and improved.