布鲁氏菌病规范化治疗管理现状研究

Study on the Management Standardization of Treatment Status of Brucellosis

目的开展布病患者规范化治疗管理现状调查,为科学防治布病提供科学依据。方法分析2013年滨州市布病临床治疗方案及预后情况。结果 2013年滨州市共报告布病病例178例,发病率4.58/10万,与2012年(115例)相比上升54.78%。此次共调查2013年1月—2013年8月病例共124例,实际调查108例,其中门诊病例13例,住院病例95例。采用两类及以上药物联合治疗64例,占80.0%(64/80),16例采用单药治疗,占20.0%。联合治疗方案前3位为:利福霉素类+多西环素+左氧氟沙星15例,利福霉素类+头孢类10例,利福霉素类+左氧氟沙星8例。95例住院病例常用药物前五位依次为利福霉素钠53例,左氧氟沙星39例,多西环素33例,利福平30例,头孢类26例;13例门诊患者应用利福平9例,左氧氟沙星3例,复方新诺明和链霉素各2例、四环素1例。108例布病患者中104例经治疗后痊愈,仅4例患者仍有发热、乏力、多汗,其中1例有髋关节疼痛而丧失劳动能力。结论当前各医疗机构基本能够遵循早期、联合、足量、足疗程的用药原则,疾控机构应进一步做好布病患者全疗程服药管理工作,减少自行停药现象的发生。

Objective To investigate therapeutic status of brucellosis patients, and to provide a scientific basis for prevention and control of brucellosis. Methods The clinical treatment and prognosis of brucellosis in Binzhou city in 2013 were analyzed.Results Binzhou City reported a total of 178 cases of brucellosis in 2013, incidence rate was 4.58/10 million.Compared with the 115 cases in 2012,it was increased of 54.78%. A total of 124 cases were investigated from August 2013 to January 2013.108 cases were investigated, 13 cases were out of hospital, 95 cases were in hospital.There was 64 people used two kinds of medicine combined treatment, accounting for 80%（64/80）.16 people used a single drug treatment, accounting for 20%.The top 3 of the combined treatment options： 15 cases of rifamycin ＋ doxycycline ＋ levofloxacin, 10 cases of rifamycin ＋ cephalosporins, 8 cases of rifamycin ＋ levofloxacin. 95 cases of hospitalized cases commonly used drugs before five sequentially for rifamycin sodium（53 cases）, levofloxacin（39 cases）, doxycycline（33 cases） rifampicin（30 cases）,cephalosporins（26 cases）.13 outpatients used rifampicin（9 cases）, levofloxacin（3 cases）, compound sulfamethoxazole and streptomycin tetracycline（2 cases）, tetracycline（1 cases）.Among the 108 cases of brucellosis patients,104 cases were cured after treatment.Only 4 cases of patients still have a fever, fatigue, sweating, including 1 case with hip pain and loss of ability to work. Conclusion The current medication principle of various medical institutions can follow early, with a full course.The institute of Disease control should do a good management job in the whole course of medication supervision, reduce the occurrence of self withdrawal.