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中国防痨杂志 ›› 2023, Vol. 45 ›› Issue (1): 104-110.doi: 10.19982/j.issn.1000-6621.20220281

• 论著 • 上一篇    下一篇

“三位一体”的关怀服务对耐多药/利福平耐药结核病患者强化期治疗的影响

何小谋, 罗卉(), 马进宝, 任斐, 赵阿利, 袁荣   

  1. 西安市胸科医院耐药结核科,西安 710100
  • 收稿日期:2022-07-27 出版日期:2023-01-10 发布日期:2022-12-30
  • 通信作者: 罗卉 E-mail:luohui666@yeah.net

Effect of “trinity” care service on the multidrug-/rifampicin-resistant tuberculosis patients in the intensive phase

He Xiaomou, Luo Hui(), Ma Jinbao, Ren Fei, Zhao Ali, Yuan Rong   

  1. Department of Drug-resistant Tuberculosis, Xi’an Chest Hospital, Xi’an 710100, China
  • Received:2022-07-27 Online:2023-01-10 Published:2022-12-30
  • Contact: Luo Hui E-mail:luohui666@yeah.net

摘要:

目的: 分析“三位一体”的关怀服务对耐多药/利福平耐药结核病(MDR/RR-TB)患者强化期治疗的影响。方法: 采用回顾性队列研究方法,以西安市胸科医院确诊的MDR/RR-TB患者为研究对象。将2018年3月至2019年2月确诊的实施住院和社区治疗相结合的综合防治服务管理模式的223例MDR/RR-TB患者作为对照组,将2019年3月至2020年2月确诊的实施“三位一体”的关怀服务管理模式的253例MDR/RR-TB患者作为干预组。分析比较两组患者在治疗强化期的用药依从情况和失访率。结果: 干预组服药依从性好的患者占86.6%(219/253),高于对照组的54.7%(122/223),差异有统计学意义(χ2=59.189,P<0.001);干预组注射剂治疗依从性好的患者占89.8%(221/246),高于对照组的60.6%(134/221),差异有统计学意义(χ2=54.460,P<0.001)。 干预组的强化期失访率为6.3%(16/253),低于对照组的30.9%(69/223),差异有统计学意义(χ2=48.970,P<0.001)。结论: 对MDR/RR-TB患者实施“三位一体”的关怀服务管理模式,有助于提高患者的用药依从性,降低失访率,值得推广应用。

关键词: 结核,抗多种药物性, 卫生服务, 模型,组织管理

Abstract:

Objective: To analyze the effect of “trinity” care service on the multidrug-/rifampicin-resistant tuberculosis (MDR/RR-TB) patients in the intensive phase. Methods: A retrospective cohort study was conducted in the MDR/RR-TB patients diagnosed in Xi’an Chest Hospital. A total of 223 MDR/RR-TB patients diagnosed from March 2018 to February 2019 who were under the integrated prevention and control service management model combining hospitalization and community treatment were selected as the control group. A total of 253 MDR/RR-TB patients diagnosed from March 2019 to February 2020 who were implemented the “trinity” care service management model were selected as the intervention group. The treatment adherence and the rate of loss to follow-up between the two groups in the intensive phase were analyzed and compared. Results: The proportion of patients with good treatment adherence in the intervention group was 86.6% (219/253), higher than that in the control group (54.7% (122/223)), the difference was statistically significant (χ2=59.189, P<0.001). The proportion of patients with good injection treatment adherence in the intervention group was 89.8% (221/246), higher than that in the control group (60.6% (134/221)), the difference was statistically significant (χ2=54.460, P<0.001). The rate of loss to follow-up of the intervention group in the intensive phase was 6.3% (16/253), lower than that in the control group (30.9% (69/223)), the difference was statistically significant (χ2=48.970, P<0.001). Conclusion: The implementation of the “trinity” care service management model for MDR/RR-TB patients is helpful to improve the treatment adherence and reduce the rate of loss to follow-up, which is worthy of popularization and application.

Key words: Tuberculosis, multi-drug resistant, Health services, Models, organizational

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