新型结核病防治管理模式示范县建设的实施效果评价

目的评价新型结核病防治管理模式(新模式)示范县建设的实施效果,为提高结核病防治管理水平提供参考。方法收集新模式示范县建设前期(2015-2016年)及后期(2017-2018年)关于肺结核管理、诊断及治疗的相关数据,通过对比分析,评价新模式示范县建设的实施效果。结果前期及后期,重报率、排除率、确诊率和转诊到位率分别为24.33%、29.38%、45.10%和72.91%以及18.52%、22.22%、59.26%和93.64%,前期的确诊率及转诊到位率较后期低,差异均有统计学意义(P<0.05);前期的重报率及排除率较后期高,差异均无统计学意义(P>0.05)。前期及后期,病原学阳性率分别为9.70%、40.43%,前期的病原学阳性率较后期低,差异有统计学意义(P<0.05)。前期及后期,肺结核的治愈率及完成治疗率分别为82.61%、90.02%以及91.59%、97.14%,前期的治愈率及完成治疗率较后期低,差异均无统计学意义(P>0.05)。前期及后期,严重治疗副反应的转院率分别为50.98%、22.64%,前期的转院率较后期高,差异有统计学意义(P<0.05)。结论通过新模式示范县建设,规范了结核病的管理,提高了结核病的诊断及治疗水平,故新模式值得推广。

Evaluation on Implementation of a New Tuberculosis Prevention and Management Model in Building the Demonstrational County

OBJECTIVE Evaluating on implementation of a new tuberculosis prevention and management model(a new model)in building the demonstrational county, which offered references for enhancement of ability of the tuberculosis prevention and management.METHODS Collecting the relative data about tuberculosis management, diagnosis and treatment in building the new model demonstrational county in earlier period(between 2015 and 2016)and in later period(between 2017 and 2018), and evaluating on implementation of the new model in building the demonstrational county by analyzing comparatively. RESULTS Repetitive report rate, exclusive rate, definite diagnosis rate, and referral and arrival rate were 24.33%, 29.38%, 45.10%, 72.91% and 18.52%, 22.22%, 59.26%,93.64% in earlier and later periods, respectively. Definite diagnosis rate and referral and arrival rate in earlier period were lower than those in later period, and the differences were statistically significant(P<0.05). Repetitive report rate and exclusive rate in earlier period were higher than those in later period, and the differences were statistically significant(P>0.05). Etiologic positive rate were9.70% and 40.43% in earlier and later periods, respectively, and etiologic positive rate in earlier period was lower than that in later period, and the difference was statistically significant(P<0.05). Cure rate and complete treatment rate were 82.61%, 90.02% and 91.59%, 97.14% in earlier and later periods, respectively, and cure rate and complete treatment rate in earlier period were lower than that in later period, and the differences were no statistically significant(P>0.05). The transfer hospital rate due to serious treatment side reaction was 50.98% and 22.64% in earlier and later periods, respectively, and transfer hospital rate in earlier period was higher than that in later period, and the difference was statistically significant(P<0.05). CONCLUSION The tuberculosis management had been regulated. The tuberculosis diagnosis and treatment levels had been increased by building the new model demonstrational county,and so the new model was worth popularizing.