关键词: 结核,肺/诊断, 转诊和会诊, 医院,综合性

Abstract: Objective To analyze the sputum examination of TB suspects in outpatient department in general hospital,and explore the measures to increase case-finding of smear-positive TB in general hospitals. Method Data from case register in the outpatient department,sputum examination register,referral register in general hospital and TB dispensary and data from supervision to general hospital and quality control of sputum examination were collected and evaluated. Result 11,303 TB suspects were registered in 40 general hospitals where the FIDELIS(Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project has been implemented for one year,and among them 859 were smearpositive pulmonary tuberculosis(SPTB 15.6%).(2,094) cases referred to TB dispensary were smear-negative TB or without sputum examination. 1,685 cases had sputum examination,and 804 were smear positive TB(47.7%).Among them,551 were from the 1,026 cases without sputum examinations in general hospital(the smearpositive rate was 53.7%) and 253 were from the 659 smear negative TB who were checked by general hospital(the smear-positive rate was 38.4%). 25,238 TB suspects had sputum examinations in TB dispensaries,the smearpositive rate was 55.7% which was significantly different from the rate in general hospitals(P<0.05). Conclusion Many TB suspects seek medical service in general hospital at the first time.However,the case detection is not standardized in general hospital.Thus, it is efficient approach to improve case detection by setting up sputum examination sites in general hospitals,enhancing administration interventions,strengthening the system of cooperation and coordination between TB dispensary and general hospital,and the internal coordination of the general hospital,integrating the sputum examination into the routine examination items in general hospital,and strengthening the quality control,training and retraining the relevant technicians.

Key words: Pulmonary tuberculosis/diagnosis, Referral and consultation, Hospital,General