综合医院转诊结核病患者对发现结核病影响的系统评价

目的 评价近10年来综合医院及乡镇卫生院对疑似结核病和结核病患者实施报告转诊制度对提高中国结核病患者发现率的影响。方法 系统评价、Meta分析,通过原始数据计算出每个研究的RR值或RD值(率差),通过合并RR或RD值来评价总的效果;使用Excel、SPSS、RevMan软件进行统计学分析。结果 采取干预措施后随访5年,涂阳患者新登记率和新发涂阳患者登记率5年均为上升的趋势,前3年增长幅度逐年增大,从第4年开始增长幅度出现下降。漏转率合并RR值为0.36,95％CI为0.25～0.53。结论 合并的结果显示,实施综合医院转诊制度后有益于结核病患者发现率的提高。

Systematic assessment on the improvement of tuberculosis case detection through general hospital-based tuberculosis patients transferring system in China

OBJECTIVE: To evaluate the reporting and transferring system for tuberculosis (TB) patients carried out by city General Hospitals & township clinics in the last 10 years in China. METHODS: Systematic review and Meta-analysis were carried out. RESULTS: After 5 years of follow-up on the outcomes of intervention, it was found that both the rates of newly registered smear positivity and the new case registration on smear positivity had significantly been increasing during the last five years and the scale of increase was growing annually during the first three years. However, the scale of increase started to decline on the fourth year. The combined RR on the failure of transfer rate was 0.36 (95% CI: 0.25 - 0.53). CONCLUSION: The integrated outcomes showed that the ongoing reporting and transferring system in general hospital was benefit for TB case detection.