辽宁省网络直报疑似肺结核患者转诊及追踪情况分析

Referral and tracing of suspected pulmonary tuberculosis patients reported through network direct reporting system in Liaoning

目的分析2009-2014年辽宁省非结核病防治机构网络直报疑似肺结核患者的转诊追踪及到位情况,了解转诊、追踪及到位现状,探索提高非结核病防治机构报告疑似肺结核患者总体到位率的有效干预措施。方法收集整理辽宁省2009-2014年非结核病防治机构网络直报疑似肺结核患者转诊追踪到位情况数据,并进行趋势性χ2检验,以P<0.05为差异有统计学意义。结果 2009-2014年辽宁省非结核病防治机构网络直报疑似肺结核患者的转诊率为81.75%,转诊到位率为34.72%,结核病防治机构追踪率为97.97%,追踪到位率为91.59%,总体到位率为95.00%。转诊到位率(χ2趋势=283.399,P<0.001)、追踪率(χ2趋势=748.166,P<0.001)、追踪到位率(χ2趋势=177.434,P<0.001)和总体到位率(χ2趋势=112.444,P<0.001)均呈上升趋势。到位患者活动性肺结核检出率呈下降趋势(χ2趋势=312.607,P<0.001),非结核排除率呈上升趋势(χ2趋势=353.650,P<0.001)。结论针对转诊追踪各环节的综合干预措施对总体到位水平有提升作用,科学有效。注重综合性医疗机构、定点医院"住、出院"等新问题的解决,转诊追踪工作会更加全面。

Objective To understand the referral and tracing of suspected pulmonary tuberculosis（ TB） patients reported by non-TB institutions of Liaoning province through internet from 2009 to 2014,and provide evidence to improve the referral of TB patients. Methods The referral and tracing data of suspected TB patients reported in Liaoning province during this period were collected for trend χ2test. Results From 2009 to 2014,the referral rate of suspected TB patients reported was 81. 75%,the successful referral rate was 34. 72%. The tracing rate was 97. 97%,and the successful tracing rate was 91. 59%. The overall successful rate was 95. 00%. The overall successful rate（ χ2= 283. 399,P 〈0. 001）,the tracing rate（ χ2= 748. 166,P 〈0. 001）,the successful tracing rate（ χ2= 177. 434,P 〈0. 001）,the overall successful rate（ χ2= 112. 444,P 〈0. 001） showed upward trends. The detection rate of active pulmonary TB among patients with successful referral showed a downward trend（ χ2= 312. 607,P〈 0. 001）,but the exclusion rate of pulmonary TB showed an upward trend（ χ2= 353. 650,P 〈0. 001）.Conclusion The comprehensive intervention for referral and tracing of TB cases could improve the overall successful level.Meanwhile,it is necessary to strengthen the management of hospitalization and discharge in general hospital and designated TB hospital to improve the tracing of TB patients.