住院肺结核患者两种痰液处理方法依从性研究

A study on the compliance between two different sputum proeessings in hospitalized patients with pulmonary tuberculosis

目的探讨住院肺结核患者使用盛有消毒液的塑料痰缸和一次性纸塑袋处理痰液方法的依从性。方法将257例住院的痰菌阳性肺结核患者采用随机数字表法分为痰缸组和纸塑袋组，125例痰缸组患者使用含有效氯2000mg／L的消毒液痰缸处理痰液，而132例纸塑袋组患者则使用一次性纸塑袋处理痰液。出院前一周发放调查表对患者使用这两种处理痰液方法的依从性进行调查。采用中位数、四分位数间距、秩和检验对数据进行统计学描述与分析，以P〈O．05为差异有统计学意义。结果比较患者使用痰缸和纸塑袋两种方法的依从性，痰缸组依从性高者占60．8％（76／125），纸塑袋组依从性高者占80．3％（106／132），差异有统计学意义（Z=-3．401，p=0．001）。对使用地点分析显示，在病房时痰缸组依从性高者占84．8％（106／125），纸塑袋组依从性高者占81．8％（108／132），差异无统计学意义（Z=-0．625，P=0．532）；但当患者在病区走廊、检查科室及外出时，痰缸组和纸塑袋组依从性高者的构成比分别为：43．2％（54／125）和70．4％（93／132）、39．2％（49／125）和63．6％（84／132）、28．8％（36／125）和50．0％（66／132），差异有统计学意义（Z值分别为-4．554、-4．507、-4．152，P值均〈0．05）。结论两组患者在病房使用时依从性没有明显差异，当患者离开病区时纸塑袋使用依从性优于痰缸，说明根据患者的需求选择不同的痰液处理方法，更有利于医院内痰液的有效管理。

Objective To explore the compliance between two different sputum processings, plastic sputum cylinder with the disinfectant and plastic bag of disposable, in hospitalized patients with pulmonary tuberculosis （TB）. Methods According to random number table method, 257 hospitalized TB patients with sputum positive patients were divided into two groups： group A （n= 125）, sputum were processed using cylinders with disinfectant which containing 2000 mg/L chlorine; group B （n= 132）, sputum were processed using the disposable plastic bag. A questionnaire was implemented one week before patients discharging from hospital, in order to explore the compli- ance between two different sputum processings. Data were analyzed using median, inter-quartile range and rank sum test, P〈0.05 was considered statistically significant. Results Comparing sputum cylinder group with paper plastic bag group, the rates of patients with high compliance were statistically different （60.8% （76/125） vs. 80.3% （106/132）; Z 3. 401, P=0. 001）. Considering only the location specific, compliances of sputum cylin der group and paper plastic bag group were not statistically significant when treated in the ward （84.8 %（106/125） vs. 81.8%（108/132）; Z=-0. 625, P=0. 532）; but when patients being treated in the corridor or examination departments or when they going out, the compliances were statistically significant （43.2% （54/125） vs. 70.4%（93/132）, 39.2% （49/125） vs. 63.6% （84/132）, 28.8% （36/125） vs. 50.0% （66/132）; Z values were -4.554, -4.507, 4. 152, and all P values 〈0.05）. Concision There is no significant difference between the two groups in the ward, however, when patients going out of the ward, the compliance of using plastic bag is better than that of using phlegm cylinder, indicating that choosing different sputum processing according to needs of TB patients will help to the management of sputum in hospital.