北京市西城区332例新涂阳肺结核患者治愈影响因素分析

目的 探讨新发涂阳肺结核患者的治愈情况及影响因素,以提高治愈率。方法 利用肺结核患者登记本、管理卡片、病历资料以及结核病管理信息系统对2009—2015年北京市西城区结核病防治所门诊登记管理的332例新涂阳肺结核患者基本特征及治疗情况进行分类统计。从中选取7个可能影响新涂阳肺结核患者治愈的指标,应用 SPSS 17.0软件进行χ²检验及Logistic回归分析, 提供相应的P值和OR值,从而最终确定影响因素。结果 332例患者纳入本研究。其中本市户籍患者202例,占60.8%,外地户籍患者130例,占39.2%,男女比例为1.7∶1,职业分布以家务及待业为主。治愈305例,治愈率为91.9%。单因素分析结果显示户籍、患者来源、治疗前痰菌检测结果、合并糖尿病、肺部空洞及诊断延误差异有统计学意义(P<0.05),将以上变量作为自变量引入Logistic回归方程进行多因素分析,最终结果显示户籍、合并糖尿病、诊断延误,是影响新涂阳肺结核患者治愈的主要因素,其中户籍的OR值为3.819,明显高于其他影响因素的OR值,是影响新涂阳肺结核患者治愈率的最主要因素。结论 加强结核病健康教育,完善医疗保障制度,建立有效的跨区域管理运行机制,提高专科医院及综合医院医务人员诊疗能力,注重合并症的治疗等是提高新涂阳肺结核患者治愈率的关键。

Influencing factors of cure for 332 new smear-positive pulmonary tuberculosis patients in Xicheng District of Beijing

Objective To investigate the cure condition of new smear-positive pulmonary tuberculosis patients and discuss the influencing factors, so as to improve the cure rate. Methods The registration books, management cards, medical records and tuberculosis management information system of pulmonary tuberculosis patients were used to collect the relative data and the data of 332 cases of new smear-positive pulmonary tuberculosis patients were analyzed for their basic characteristics and treatments in Xicheng District Tuberculosis Control Institute of Beijing from 2009 to 2015. Seven indicators which might influence the cure condition of the new smear-positive pulmonary tuberculosis patients were selected and analyzed with the chi-square test and logistic regression analysis by SPSS17.0 software, The corresponding P value and the OR value are provided to determine the influencing factors finally. Results Totally 332 patients were included in this study, and among them, 202 patients had the city residence (60.8%) and 130 were migrant (39.2%). The male to female ratio was 1.7:1, and the main occupations of them were household work and unemployment. Totally 305 patients were cured with a cure rate of 91.9%. The single factor analyses showed that the differences in census register, patient origin, pre-treatment sputum test Results, diabetes , lung cavity and diagnosis delay were statistically significant (P<0.05).and multiple factor analyses was carried out to introduce the above variables as independent variables into Logistic regression equation, and the final result was showed that the census register, diabetes, and diagnosis delay were the influencing factors of the cure rate. The census register was the main influencing factor (OR=3.819). Conclusion To strengthen the health education about tuberculosis, reform the medical security system, set up the effective cross regional management operation mechanism, improve the medical personnel diagnosis and treatment ability in specialist hospitals and general hospitals, and pay more attention to the treatment of complication are the key measures to improve the cure rate of new smear-positive pulmonary tuberculosis patients.