应用手机短信对肺结核患者治疗管理的效果研究

目的 探索手机短信提醒对肺结核患者抗结核治疗管理的效果。方法 2014年4月-2015年12月在广西2个县纳入18~60岁的初治肺结核患者,分为短信加强组和常规管理组,均按国家要求治疗管理。对短信组发送手机短信提醒服药、取药、查痰及防治知识。结果 共纳入患者400例,每组200例。短信组服药依从性好的患者比例(79.50%,159例)较常规组高(63.50%,127例)(χ2=12.563,P<0.001)。其中18岁～和30岁～、居住地离结防机构远、初中以上、痰涂片阴性/未查痰、农村居民,短信组服药依从性(依次为88.24%,77.89%,83.45%,81.44%,79.49%,80.32%)高于常规组(依次为68.00%,63.33%,62.66%,62.82%,60.81%,63.54%)(P值均小于0.05)。短信组治疗最后一个月末按时查痰率(87.50%,175例)高于常规组(78.00%,156例)(χ2=6.323,P=0.012)。不良反应发生至报告的平均时间在短信组为(0.66±1.818)天(0~7天),常规组为(4.26±7.729)天(0~34天),( t =2.363 ,P =0.025)。结论 利用手机短信提醒可提高患者服药和按时查痰的依从性,并及时发现不良反应。可针对适当的人群,利用该手段对患者进行加强管理。

Effect of text message to enhance the management of pulmonary tuberculosis patients

Objective To explore the effect of applying text message to enhance the management of pulmonary tuberculosis(PTB)patients. Methods Newly diagnosis PTB cases aged from 18 to 60 years old were enrolled into the text massage-enhanced group(TME group)and regularly-management group(RM group)with standardized case management in April 2014 to December 2015 at 2 counties of Guangxi.Standardized case management was performed on two groups.Text messages were sent to remind the patients in TME group to take and get anti-TB medicine regularly,and to accept sputum tests and obtain knowledge on TB prevention. Results A total of 400 patients were enrolled and divided equally to each group.The patients with better adherence were more in the TME group(79.50%,159)than the RM group(63.50%,127 cases;χ2=12.563,P=0.000).Patients whose aged above 18 years old and 30 years old with negative sputum smear tests or no smear tests and living in rural areas that far from the TB clinics were better compliance in the TME group(88.24%,77.89%,83.45%,81.44%,79.49%,80.32%)than the RM group(68.00%,63.33%,62.66%,62.82%,60.81% and 63.54%;P<0.05).The rate of regularly having sputum smear tests in the last month was higher in the TME group(87.50%,175 cases)than the RM group(78.00%,156 cases;χ2=6.323,P=0.012).The average time between adverse effects occurring and reporting were 0.66±1.818 days(0-7 days)in the TEM group and 4.26±7.729 days(0-34 days)in the RM group( t =2.363,P=0.025). Conclusion Text massage is helpful for the PTB patients to improve compliance of taking medicine and sputum smear tests,and it detects adverse effects in time.We should use it to strengthen the treatment management of the patients.