2006-2015年某结核病专科医院工作人员结核病发病特点分析

Analysis of features of tuberculosis in employees from a tuberculosis hospital between 2006 and 2015

目的对结核病专科医院工作人员结核病发病特点进行分析，探索其结核病发病高危人群。方法回顾性分析2006--2015年间某结核病专科医院8403名工作人员年度体检和因症就诊发现结核病的情况，通过影像学表现、痰结核分枝杆菌检查、结核菌素皮肤试验、结核血清学检验、病理学检查等分析结核病专科医院工作人员结核病发病特点。结果2006--2015年10年间某结核病专科医院工作人员共有30例新发结核病患者，平均年发病率为357／10万（30／8403）；30例患者按年龄分为18岁、25岁、30岁、35岁、40岁、45岁、50岁、5560岁等8个年龄组，发病率分别是694／10万（4／576）、504／10万（5／992）、671／10万（8／1192）、274／10万（5／1823）、182／10万（3／1648）、272／10万（3／1101）、140／10万（1／716）、282／10万（1／355）；根据在该医院工作时间的长短分0年，6年，11年，16年，21年，26年，31年，3640年共8个时间段，分别有7例、4例、11例、4例、2例、2例、0例、0例患者。30例患者中有临床一线医务人员25例；肺结核患者26例，肺外结核患者4例；年度体检发现肺结核13例，因症就诊发现肺结核13例。结论结核病专科医院工作人员结核病发病率较高，35岁以下及在医院工作15年内的工作人员是结核病高危人群。定期体检和及时因症就诊是发现结核病的重要手段。

Objective To analyze features of tuberculosis in the employees working at a tuberculosis hospital, and explore the high-risk population of developing tuberculosis. Methods Data of tuberculosis, employees from a tuberculosis hospital during the year of 2006 to 2015, including imagings, sputum Mycobacteriurn tuberculosis, tuberculin skin test, serological test for tuberculosis, pathological examination, were retrospectively analyzed to sum up features of employees working at tuberculosis hospital. Results During the period of 2006 to 2015, a total of 30 employees were newly diagnosed as tuberculosis, with a mean annual rate of 357/100 000 （30/8043）. According to their ages, patients were divided to 8 groups, 18-- years old, 25-- years old, 30--years old, 35-- years old, 40--years old, 45--years old 50-- years old and 55-- years old, the incidence rates of the 8 groups were 694/100 000 （4/576）, 504/100 000 （5/992）, 671/100000 （8/1192）, 274/100 000 （5/1823）, 182/100 000 （3/1648）, 272/100 000 （3/1101）, 140/100 000 （1/716） and 282/100 000 （1/355）, respectively. Based on the lenth of employment, there were 7 cases, 4 cases, 11 cases, 4 cases, 2 cases, 2 cases, 0 and 0, respectively in 0-- years, 6- years, 11- years, 18-- years, 21- years, 26-- years, 31- years, 36--40 years groups. Of the 30 petients, 25 were/irst-line clinical staff; 26 developed pulmonary tuberculosis, and 4 developed extra pulmonary tuberculosis; 13 were diag- nosed by annual physical examination and 13 were found by symptomatic visits. Conclusion There is a higher in- cidence rate of tuberculosis in the employees working at tuberculosis hospitals. The employees younger than 35 years or who engaged in clinical practice within 15 years are the high-risk population of tuberculosis. Regular physical examination and prompt visits due to symptoms are important approaches to diagnose tuberculosis.