湘南铁路地区急性菌痢高发原因分析及防治对策探讨

「目的」为探索湘南铁路地区急性菌痢高发原因及防治对策。「方法」收集１９９４～１９９８年医院病例资料，并作１９９９年现状调查，运用危害分析和关键控制点（ＨＡＣＣＰ）和规范管理（ＧＭＰ）方法实施防治对策，作效果观察。「结果」误诊病例多，铁路流动人口多，菌痢传入机会频率高，环境卫生质量差，是报告发病率高的原因，运用ＨＡＣＣＰ和ＧＭＰ方法后，误诊率由原来４２％下降到８％，发病率（６８．３４／１０万）比前五年年均２１２．５／１０下降了６７．８％。「结论」诊断欠规范、误诊病例多，是报告发病率的关键因素；其次为铁路客运从业人员接触传染机会多、流动人员多，运用ＨＡＣＣＰ和ＧＭＰ管理方法能够有效地控制急性菌痢的高发病率。

The Investigation on High Incidence Rate and Prevention Program of Actute Bacillary Dysentery in Railway District of South Hunan Province

Objective] To probe the incidence rate and prevention progeam of acute bacillary dysentery in railway district of south Hunan Province.[Methods] During the past five years, date of acute bacillary dysentry cases were collected and analyzed. The hazard anaoysis critical control point (HACCP) and the good manufacturing practice (GMP) were uscd to implement prevention program. The effect was observed.[Result] The main High incidence rate of acute bacillary dysentery were caused by erronaous diagnoses, floating population in railway and bad environmental sanitation. The incidence rate decreased form 212.5/100000 to 68 34/100000 after the HACCP and the GMP were implemented.[Conclusion] Erroneous diagnoses were the key factor of high incidcnce rate. Morbidty of working people in railway was higher because of more opportunistic infection. Implemeting the HACCP and the GMP can control the high morbidity of acute bacillary dysentery effectively.