2015年湖南省晚期血吸虫病治疗救助特征分析

目的了解2015年湖南省晚期血吸虫病(晚血)治疗救助患者的特点和分布现状,为完善晚血治疗救助政策提供参考依据。方法按照晚血治疗救助标准,对湖南省2015年在册晚血患者进行核查与确认,对符合晚血治疗救助标准者进行流行病学调查,分析比较救助患者在人口学、诊疗史及治疗救助等方面的特征。结果 2015年湖南省救治晚血患者3 850人,男性2 664人(69.19%),女性1 186人(30.81%),主要分布在岳阳、常德、益阳3个血吸虫病流行市。晚血救治患者中腹水型2 369例(61.53%),巨脾型1 466例(38.08%),结肠增殖型及侏儒型15例(0.39%);平均年龄(62.94±11.67)岁,以60岁以上高年龄人群为主(64.31%)。晚血救治患者首次确诊平均年龄(53.85±21.32)岁,主要集中在40~60岁(68.57%);平均患病年限(9.58±10.06)年,主要为10年以内(75.95%);首次确诊血吸虫病到首次确诊晚血平均历时(22.33±14.20)年。晚血救治医院以县级为主(76.57%),患者救治有效率为94.46%,享有医保(农村合作医疗、城镇医保等)者占86.57%。结论湖南省晚血救治患者数量较多,临床治愈率偏低,晚血救治任务仍然较重。腹水型、高年龄晚血患者是治疗救助的重点。

Analysis of characteristics of medical assistance to advanced schistosomiasis patients in Hunan Province, 2015

Objective To understand the current distribution and characteristics of advanced schistosomiasis patients who accepted medical assistance in Hunan Province in 2015， so as to provide the evidence for perfecting the policy and measures of the medical assistance to advanced schistosomiasis patients. Methods The patients who had been diagnosed as advanced schistosomiasis were verified and confirmed according to the standard of the medical assistance to advanced schistosomiasis patients in Hunan Province in 2015. The epidemiological survey was conducted to investigate the demographic characteristics， history of diagnosis and treatment， and medical assistance to these persons. Results There were 3 850 advanced schistosomiasis patients who accepted the medical assistance in Hunan Province in 2015， and among them， 2 664 patients were male （69.19%）， and 1 186 were female （30.81%）. Most of them （92.82%） came from the main schistosomiasis endemic areas， such as Yueyang， Changde and Yiyang. There were 2 369 cases of ascites （61.53%）， 1 466 cases of splenomegaly （38.08%）， 15 cases of colon proliferation and dwarf （0.39%）. The mean age of advanced schistosomiasis patients who accepted the medical assistance was （62.94 ± 11.67） years old， with 64.31% of them being more than 60 years old. The age of initial diagnosis of advanced schistosomiasis was （53.85 ± 21.32） years old， and it was concentrated in 40-60 years old （68.57%）. The mean duration of advanced schistosomiasis was （9.58 ± 10.06） years， and it was mainly distributed in 10 years （75.95%）. The mean duration from initial diagnosis of schistosomiasis to advanced schistosomiasis was （22.33 ± 14.20） years. The priority of the medical assistance to advanced schistosomiasis patients was given to the county hospitals （76.57%）； and the effective rate of assistance was 94.46%. Totally 86.57% of the patients with advanced schistosomiasis got the medical insurance （rural cooperative medical care， urban medical care， etc.）. Conclusions The burden of the medical assistance to advanced schistosomiasis patients is still heavy because of many patients and low cure rate in Hunan Province. The ascites patients and high age patients should be the important objects of the medical assistance.