银川市医疗机构住院患者中发现的隐性梅毒规范治疗情况及相关因素调查

Investigation on the treatment and related factors of latent syphilis among inpatients of medical institutionsin Yinchuan

目的调查银川市医疗机构住院患者中发现的隐性梅毒病例治疗情况,为改进梅毒诊疗服务提供依据。方法通过传染病报告信息管理系统下载2014-2016年银川市医疗机构隐性梅毒报告病例,采用国家制定的调查问卷,对来自于住院患者报告的隐性梅毒病例的治疗情况进行调查,使用Logistic回归模型分析其相关因素。结果调查银川市36家医疗机构住院患者中筛查发现的隐性梅毒病例1442人中,2014-2016年住院期间规范治疗率分别为18.37%、39.92%和40.61%,呈逐年上升趋势(χ^(2)_(趋势)=49.77,P<0.001),3年平均规范治疗率为33.56%。配备有苄星青霉素的医疗机构比例为83.33%(30/36)。多因素Logistic回归分析显示,影响住院发现的隐性梅毒患者使用苄星青霉素规范治疗的因素有年份、医疗机构类型、诊疗科室;妇幼专科医院(47.92%)高于综合医院(31.36%),妇产科(48.94%)高于外科和内科(29.95%、33.48%)。结论银川市医疗机构住院患者中发现的隐性梅毒病例规范治疗率逐年增长,但仍然较低,不利于传染源的控制。应制订医疗机构住院患者中隐性梅毒治疗指南或临床路径,加强隐性梅毒治疗,控制梅毒流行。

Objective To investigate the treatment of latent syphilis among hospitalized patients in Yinchuan medical institutes,and to provide prevention and control measures for improving the diagnosis and treatment of syphilis.Methods We conducted a questionnaire survey among inpatients derived from the Infectious Disease Reporting Information Management System.The factors associated with latent syphilis treatment were analyzed using the Logistic Regression.Results Among the 1442 cases of latent syphilis in 36 medical institutions in Yinchuan,the average proportion of treatment with benzathine penicillin during hospitalization was 33.56%,showing an increasing trend from18.37%in 2014 to 40.61%in the 2016 year by year(χ^(2)=49.77,P<0.001)The proportion of medical institutions equipped with benzathine penicillin was 83.33%(30/36).Multi-logistic regression analysis showed that the year of diagnosis,level of medical institutions,department of diagnosis were significantly associated with the treatment of latent syphilis;the proportion of latent syphilis patients treated with benzathine penicillin in women and children hospitals(47.92%)was higher than that in general hospitals(31.36%),in gynecology and obstetrics(48.94%)was higher than that in other departments(29.95%-33.48%).Conclusions The proportion of treatment with benzathine penicillin for latent syphilis by screening among inpatients in medical institutions in Yinchuan increased year by year,but it was still very low,which was not enough to prohibit the spread of syphilis.It is necessary to develop guidelines or clinical pathways for latent syphilis among hospitalized patients in medical institutions,strengthen the treatment of latent syphilis and control the epidemic of syphilis.