深圳市2011—2016年非结防机构报告疑似肺结核转诊追踪情况

Referral,tracing and diagnosis status of suspicious tuberculosis patients reported by non-TB control institutions in Shenzhen,2011-2016

目的分析深圳市非结核病防治机构(简称"非结防机构")网络直报疑似肺结核患者的转诊、追踪、到位及诊断情况,探索提高肺结核患者发现水平的措施。方法收集2011—2016年深圳市结核病信息管理系统中非结防机构报告的151 295例疑似肺结核患者的转诊、追踪、到位、诊断等信息资料,对不同年度疑似患者的转诊到位率、追踪到位率、总体到位率、到位后肺结核患者检出率及非结防机构对肺结核患者发现的贡献率进行统计学分析。结果 2011—2016年非结防机构网络报告疑似肺结核患者151 295例,转诊到位57 681例(38.12%),追踪到位44 080例(47.09%),其他到位37 443例(40.0%),总体到位率139 204例(92.01%)。转诊到位率从34.90%提高到43.77%,总体到位率从87.31%提高到95.21%,差异均有统计学意义(P<0.05)。追踪未到位的主要原因为电话地址不详4 257例(35.21%)、查无此人3 902例(32.27%)、拒绝就诊1 167例(9.65%)等。到位者活动性肺结核检出率为14.13%(19 667/139 204),结核病排除率为85.87%(119 537/139 204)。非结防机构对活动性肺结核患者和涂阳肺结核患者发现的贡献率分别为80.12%(19 667/24 547)和80.37%(9 788/12 179)。结论深圳市非结防机构网络报告疑似肺结核患者总体到位率维持在较高水平,这些患者是深圳市肺结核发现的重要来源,但要进一步提高疑似肺结核患者信息采集的真实性和准确性。

Objective To analyze the referral,tracing and diagnosis status of suspicious tuberculosis（TB） patients reported by non-TB control institutions in Shenzhen City from 2011 to 2016,and explore the measures of improving the discovery level.Methods The data of referral,tracing and diagnosis of 151 295 suspected pulmonary tuberculosis（PTB）patients reported by non-TB institutions were collected and analyzed statistically in Shenzhen City from January 2011 to December 2016.Results A total of 151 295 suspected PTB patients were reported by non-TB institutions,57 681（38.12%）cases were referral arrival,44 080（47.09%）cases were tracing arrival,37 443（40.00%）cases were arrival by other ways,and the number of total arrival cases was 139 204（92.01%）.The referral rate was increased from 34.90% in 2011 to 43.77% in2016,the total arrival rate was increased from 87.31% in 2011 to 95.21% in 2016,and the differences were statistically significant（P0.05）.The main causes of tracing non-arrival included unknown of the telephone number and address（4 257,35.21%）,no such person（3 902,32.27%）and refusing to see a doctor（1 167,9.65%）.Among the arrival patients,the detection rate of active PTB cases was 14.13%（19 667/139 204）and the exclusion rate was 85.87%（119 537/139 204）.The contribution rate of active PTB cases detected by the non-TB institutions was 80.12%（19 667/24 547）,and the contribution rate of smear positive PTB cases detected by the non-TB institutions was 80.37%（9 788/12 179）.Conclusions The total arrival rate of suspected PTB patients reported by non-TB institutions is maintained at a high level in Shenzhen City from 2011to 2016.These referral patients are the important source for PTB finding.However,we still should further improve the authenticity and accuracy of the information of suspected PTB patients.