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中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (6): 340-346.

• 论著 • 上一篇    下一篇

2005—2009年北京市平谷区肺结核患者的发现与治疗管理分析

李国红 苗润青 于永龙 王月珍   

  1. 北京市平谷区结核病预防控制中心
  • 收稿日期:2011-04-08 出版日期:2011-06-20 发布日期:2012-03-16
  • 通信作者: 李国红 E-mail:cr6578@126.com

 Analysis of case detection and treatment management of pulmonary tuberculosis in Pinggu district from 2005 to 2009

 Li Guohong, Miao Runqing, Yu Yonglong, Wang Yuezhen   

  1.  Pinggu District Center of Tuberculosis Prevention and Control; Beijing 101200; China
  • Received:2011-04-08 Online:2011-06-20 Published:2012-03-16
  • Contact: Li Guohong E-mail:cr6578@126.com

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摘要： 目的 通过回顾分析2005—2009年北京市平谷区肺结核患者的发现登记和治疗管理情况，探索适合农村山区传染性肺结核患者的发现方式和治疗管理模式。 方法 采用描述流行病学方法, 对平谷区2005—2009年563例肺结核患者发现方式、登记数据、管理模式和治疗转归进行分析。2005—2009年北京结核病控制研究所下达新涂阳发现任务指标总数为280例。 结果 2005—2009年全区共登记治疗管理户籍人口活动性肺结核患者563例，山区、半山区肺结核患者381例，占67.7%，新登肺结核年均登记率为32.86/10万；平原地区新登肺结核患者182例，占32.3%，新登肺结核年均登记率为22.12/10万。山区、半山区肺结核患者登记率明显高于平原地区（χ2=19.562，P＜0.001）。2005—2009年年平均涂阳肺结核登记率为13.27/10万，发现方式以转诊和因症就诊的被动发现方式为主，达94.1%（530/563），新涂阳发现任务指标平均完成率为83.9%（235/280）。金海湖镇为我区肺结核的高发地区，2005—2009年新登活动性肺结核患者118例，占全区的21.0%，其中合并有矽肺的涂阳肺结核患者22例，占金海湖镇新发涂阳肺结核患者的37.9%（22/58）。563例患者100％实施现代结核病控制策略（DOTS），全部采用家庭成员为督导员的全程督导管理方式，新涂阳患者强化期末平均痰菌转阴率为79.6%（187/235），新涂阳患者治愈率88.9%（209/235）。 结论 将结核病控制工作的重点放到农村边远山区，及时主动发现新涂阳肺结核患者，并给予彻底、规范化的治疗，有效控制肺结核病在人群中传播。

关键词: 结核, 肺/预防和控制, 登记, 北京市

Abstract: Objective Through retrospective analysis of the status ofpulmonary tuberculosis(PTB) registration and treatment management of Pinggu District from 2005 to 2009, to explore the PTB case detection and management model in mountainous and rural areas. Methods Five hundred and sixty-three PTB cases registered from 2005 to 2009 were analyzed in terms of case detection method, reporting and management and treatment outcome by descriptive epidemiological method. The task issued by Beijing research institute of Tuberculosis Control for Pinggu district in these 5 years was to detect a total of 280 cases PTB new smear-positive PTB patients. Results From 2005 to 2009, a total of 563 active PTB cases were registered in Pinggu District, of which 381 cases were from mountainous areas, accounting for 67.7% with the average annual registration rate of 32.86/100 000; the remaining 182 PTB cases were from plain areas, accounting for 32.3%, with the average annual registration rate of 22.12/100 000. The registration rate of TB patients in mountainous areas was significantly higher than that in plain areas(χ2=19.562, P<0.001). From 2005 to 2009, the average annual registration rate of smear-positive PTB patients was 13.27/100 000, the case detection model of these patients were mainly through referral and passive case finding, accounting for 94.1%(530/563), the average task completion rate was 83.9%(235/280). Jinhai town is a high TB prevalence area in Pinggu district. In these 5 years, a total of 118 active PTB cases were registered in this area, accounting for 21% of that in Pinggu District, among which 22 cases were complicated with silicosis accounting for 37.9% (22/58). All patients were managed under DOTS by household supervisor, and the smear conversion rate of new smear-positive PTB patients was 79.6%(187/235) at the end of intensive periods and the cure rate was 88.9%(209/235).  Conclusions The focus of TB control work should be placed in rural and mountainous area. In order to effectively control the transmission of PTB, we should discover the new smear positive PTB patients timely and proactively, and give standardized and thorough treatment.

Key words: tuberculosis, pulmonary/prevention and control, registries, Beijing city

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