信息化技术在涂阳肺结核患者居家隔离中的应用初探

doi:10.3969/j.issn.1000-6621.2018.09.021

摘要/Abstract

摘要：

为了解全球定位系统(global positioning system,GPS)技术和移动终端(“本研究采用手机”)健享互联应用程序(application,APP)(简称“手机APP”)对结核病患者居家隔离期间活动轨迹和服药情况进行监测的情况,本研究选择深圳市南山区慢性病防治院(简称“南山慢病院”)2017年8—11月登记管理并自愿签署居家隔离治疗知情同意书的10例处于传染期但病情较轻的涂阳肺结核患者为研究对象。对10例患者居家隔离期间进行手机APP管理,2周(即1个居家隔离周期)后到南山慢病院进行痰涂片检查,依据痰涂片结果决定解除隔离或继续隔离。最终进行1个居家隔离周期者7例,进行2个居家隔离周期者3例;使用APP上传服药视频率≥95%者8例;3例患者居家隔离期间全程在家庭范围内活动,7例患者未能全程在家庭范围内活动但活动轨迹明晰。7例外出者中,2例患者因病外出就诊5次均上报;2例患者因病和其他事由外出3次和4次均未上报;1例患者因病外出就诊4次均上报,但因搬家外出1次未上报;1例患者因就医检查外出2次均上报,但因其他事由外出3次均未上报;1例患者因就医检查外出5次均上报,因购买生活用品外出1次未上报。结果表明,基于GPS技术的涂阳肺结核患者居家隔离治疗模式,为精确有效地隔离涂阳肺结核患者、减少结核病传播可提供防控监督依据。

关键词: 结核, 肺, 病人隔离, 便携式电话, 地理信息系统, 管理信息系统

Abstract:

To explore the application of global positioning system (GPS) technology and mobile terminals application (APP) to monitor the activity trajectory and medication of tuberculosis (TB) patients during their home quarantine, 10 smear-positive mild TB patients with voluntary signing the informed consent of home quarantine, who were newly treated and managed at Nanshan Center for Chronic Disease Control from August 2017 to November 2017, were selected as the research subjects. The ten patients were managed by the doctors with “Jian xiang hu lian” APP. After two weeks of quarantine (one home quarantine cycle), the patients went to Nanshan Center for Chronic Disease Control for sputum smear examination. According to the results of sputum smear, the doctors decided to cease or continue the quarantine. In the end, 7 cases carried out 1 home quarantine cycle, and 3 cases performed 2 home quarantine cycles. Eight patients’ medication video upload rates were above 95%. Three patients were at home during the whole period of quarantine, while 7 patients were unable to stay at home during the whole period of quarantine, but the trajectories were clear. Among the 7 patients who were out of their homes, 2 patients went to see a doctor 5 times with reporting to the doctor. Two patients respectively went out 3 times and 4 times due to illness and other matters without reporting to the doctor. One patient went to see a doctor 4 times with reporting to the doctor, but went out 1 time for moving house without reporting to the doctor. One patient went out 2 times for medical examination with reporting to the doctor, but went out 3 times due to other matters without reporting to the doctor. One patient went out 5 times for medical examination with reporting to the doctor, but went out 1 times for purchasing daily necessities without reporting to the doctor. The results showed that the home quarantine model based on GPS technology could provide control and supervision basis for the precise and effective quarantine of smear-positive TB patients and reducing the transmission of TB.

Key words: Tuberculosis, pulmonary, Patient quarantine, Portable telephone, Geographic information system, Management information system

刘盛元,杨亚蕊,陈亮,郭旭君,钟涛,朱闵敏,王健,李盛斌,张洁,宋春发,杨南森,马剑平. 信息化技术在涂阳肺结核患者居家隔离中的应用初探[J]. 中国防痨杂志, 2018, 40(9): 1012-1018. doi: 10.3969/j.issn.1000-6621.2018.09.021

Sheng-yuan LIU,Ya-rui YANG,Liang CHEN,Xu-jun GUO,Tao ZHONG,Min-min ZHU,Jian WANG,Sheng-bin LI,Jie ZHANG,Chun-fa SONG,Nan-sen YANG,Jian-ping MA. Application of information technology in home quarantine of patients with sputum smear positive pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2018, 40(9): 1012-1018. doi: 10.3969/j.issn.1000-6621.2018.09.021

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社会人口学特征	患者例数	社会人口学特征	患者例数
性别		家庭年收入情况(万元)
男	3	2~	1
女	7	5~	6
年龄(岁)		10~	3
≤19	1	医药费报销情况
20~	8	自费	4
≥40	1	医疗保险(自费比例≥10%)	3
文化程度		医疗保险(自费比例<10%)	3
初中	2	职业
高中	4	职员	6
大学及以上	4	工人	2
户籍		学生	1
非深圳户籍	9	待业	1
深圳户籍	1
有无单独居室
有	8
无	2

诊疗信息	患者例数	诊疗信息	患者例数
抑郁量表得分		治疗前痰涂片检查情况
<5	6	4~5条/300个视野	2
≥5	4	+	3
焦虑量表得分		++	3
<5	7	+++	1
≥5	3	++++	1
咳嗽、咳痰症状		治疗前痰培养情况
有	8	阳性	10
无	2	阴性	0
患者类别		耐药情况
初治	10	非耐药	10
复治	0	耐药	0