互联网＋医疗模式下肺结核诊疗现状分析

A cross-sectional study on tuberculosis diagnosis and treatment in the Internet ＋ medical mode

目的分析在互联网诊疗的肺结核患者与住院肺结核患者各自的特征，并探讨肺结核在“互联网＋医疗”模式下诊疗的优缺点。方法通过IBM SPSS Statistics 23统计软件的“选择个棠”功能随机抽取2015年6月至2016年1月在上海市公共卫生临床中心住院治疗的肺结核患者i00例为对照组；随机抽取同时段该院医生在好大夫在线（www．haodf.com）诊治的确诊或疑似肺结核患者100例为研究组。收集两组患者性别、年龄、现住址等基本信息，以及肺结核相关临床资料、实验室资料的提供情况。计算患者所提供病史资料的得分情况，临床资料、实验室资料每提供一：页得1分，未提供项记为0分，满分为25分。使用IBM SPSS Statistics 23对相应数据进行统计分析，年龄与病史资料得分使用Mann-Whitney U检验，计数资料使用χ2检验，以P〈0．05为差异有统计学意义。结果研究组男性53例（53．0％），女性47例（47．0％）；对照组男性73例（73．0％），女性27例（27．0％），差异有统计学意义（χ2=8．58，P=0．003）。研究组平均年龄为（32．7±12．4）岁，对照组平均年龄为（50．8±19．4）岁，差异有统计学意义（U=2405．50，P〈0．001）。研究组现住址主要为上海（12．0％）、河北（8．0％）、山东（8．0％）、广东（8．0％）；对照组主要为上海（70．0％）、浙江（10．0％）、江苏（8．0％）。研究组病史资料评价平均得分为（4．6±3．3）分，对照组为（19．3±2.4）分，差异有统计学意义（U=16．50，P〈0．001）。结论“互联网＋医疗”时代肺结核患者可以突破空间屏障，优化诊疗体验。同时面临着患者提供的病史资料不全、老年患者不会使用互联网，以及基层医院应加快互联网医疗建设等诸多挑战。

Objective To analyze the characteristics of （TB） who were respectively exposed in the Internet ＋ medical the advantages and disadvantages of TB diagnosis and treatment two groups of patients suffering from tuberculosis mode and the traditional medical mode, and discuss in the Intemet ＋ medical mode. Methods Through random sampling method, with ＂select cases＂ which is a random sampling function of IBM SPSS Statistics 23, selecting 100 patients with pulmonary tuberculosis （PTB） as the control group who were hospitalized in Shanghai Public Health Clinical Center from June 2015 to January 2016,in the same way, choosing 100 patients suffering from PTB as the research group who were diagnosed and treated on the website, www. haodf, com, by a doctor worked in the same hospital in Siaanghai. Collecting the general informations, such as gender, age and address, clinical data and laboratory data related to tuberculosis of the two group patients. Calculating the score respectively evaluating the case history of the patients in the two groups. If one item of the clinical data or laboratory data was provided, 1 point would be obtained, otherwise no point would be obtained and the maximum score was 25 points. Corre- sponding data was analyzed statistically by IBM SPSS Statistics 23. The data of age and case history score was ana- lyzed by Mann-Whitney U test, and enumeration data was analyzed by Chi-square test. The difference was consi- dered statistically significant when the P value was less than 0.05. Results There are 53 male patients in the re- search group,which account for 53.0% while the control group has 73 male patients. The difference is statistically significant （χ2 =8.58,P=0. 003）. The average age in the research group is （32.7±12.4） years old, while the average age in the control group is （50.8± 19.4） years old. The difference is statistically significant （U= 2405.50, P〈0. 001）. The main provinces where the patients were living in the research group are Shanghai （12.0%）, Hebei （8.0%）, Shandong （8.0%） and Guangdong （8.0%）. The main provinces in the control group are Shanghai （70.0%）, Zhejiang （10.0%） and Jiangsu （8.0%）. The average score evaluating the case history in the research group is （4.6±3.3） points while the score in the control group is （19.3±2.4） points. The difference is statistically significant （U=16.50,P〈0. 001）. Conclusion Patients in the era of Internet ＋ medical can break through the barrier of space. The experience of diagnosis and treatment will be optimized. However, we also face many challen- ges. The case history data of many patients may be provided incompletely. Some elderly patients may have difficulty in using Internet and then can＇t enjoy the convenience of the Internet ＋ medical mode. The primary health care hos- pital should speed up the construction of internet medical care.