世行贷款方案治疗肺结核失败227例原因分析

目的 从住院复治肺结核病人分析世行贷款结核病控制方案治疗失败的原因。方法 随机抽取1998－2000年间经项目治疗复发的肺结核病例，按症状、X线、痰菌、治疗方案及疗程、停药原因及督导管理情况等进行统计分析。结果 三年中经项目治疗复发的肺结核病患共227例，占同期住院复治病人的33．8％，且呈上升趋势，失败的原因是医、患两方面的：如入选对象把关不严、督导（DOTS）管理不到位、药物副反应处理不及时或不正确、经济困难和不规律用药等是造成失败的直接原因。结论 项目治疗效果欠佳，建议政府加大对结核病控制经费的投入和强化全程督导化疗（DOTS）管理以及调整化疗方案。

Analysis of the reason for the failurce of the Antituberculosis project credited from World Bankon 227 patients

To analyze and understand the reason for the failure of the tuberculosis project credited from the World Bank among readmited in hospital parients.Method Recurrent tuberculous patients treated through the Project from 1998-2000 were randomly selected.The variables for the statistical analysis included symptoms, X-ray, sputum bacillus, therapy schema the course of treatment,reason for discontinuing treatment and state of supervision.Results In 3 years,the number of the patients added up to 227,with a rising tendency over time.It consisted of 33.8% all recurrent patients in hospital.The reason for the failure included such as:not selecting patients properly,poor surpervision, mistreatment,side-effects,lack of money and irresponsibe therapy.These are the direct failure reasons.Conclusion The curative effects of the Project is not as good as expected.One way of solving the problem is to have financial investment from the government and to strengthen the process of administration and supervision.