新发涂阳肺结核病诊断延迟分析

目的　了解新发涂阳肺结核病人诊断延迟的原因。方法 查阅6县 (市)新发涂阳肺结核病人的病历，分析其延迟诊断的原因。结果 本次调查共收集诊断延迟病人108例，就诊、确诊、发现延迟的平均时间分别为4.6周、6.4周、8.7周。延迟病人首次就诊以咳嗽、咳痰、乏力为主，分别为88.9%、78.7%、37.0%。在就诊延迟者中对初始症状不重视和经济困难导致就诊延迟的分别为58.7%和34.8%。在确诊方式上，仅有10.2%的病人有痰涂片检查结果，其他均仅为X线为确诊依据。结论 病人自我保护意识较淡薄是造成就诊延迟的主要因素，而病人首次就诊症状不典型，医生重X线轻痰检的诊断方式是导致确诊延迟的主要原因。

Analysis for diagnostic delay of new smear positive patients

Objective To investigate the diagnostic delays of newly smear positive cases in Hubei.Meth ods Consulting the history of new smear positive cases in 6 counties.Results To collected 108 cases in 6 counties/cities.The average time of patient delay,doctor delay and total delay was 4.6 weeks,6.4 weeks and 8.7 weeks,respectively.The initial symptoms of delayed patients were cough (88.9%),expectoration (78.7%) and hypodynamia (37.0%),etc.The main delayed reasons were paying no attention to symptoms (58.7%),economic difficulties (34.8%).Only 10.2% of patients had sputum smear results.Other patients were only diagnosed by X ray examination.Conclusion The main reason of patient delay was that patients did not care for their own health,the main reason of doctor delay was that doctors paid more attention to X rays examination than sputum inspection.