安徽省山区涂阳肺结核患者治疗管理依从性研究

目的 了解安徽省山区涂阳肺结核患者抗结核治疗依从性及相关影响因素.方法 采用随机抽样方法,从安徽省3个山区县抽取105名涂阳肺结核病患者,并进行问卷调查.结果 105名调查对象的平均年龄为(54.02±16.37)岁,其中,男性81人,占77.1%,女性24人,占22.9%;治疗过程中出现漏服药的有16人,占15.2%;在漏服药的患者中,有50.0%是由于抗结核药物的毒副作用而停止服药或漏服药,有25.0%是因为工作忙或遗忘,因外出务工、交通不便或其他原因而漏服药的占25.0%;漏服药组与未漏服药组在医生访视次数方面差异具有统计学意义(P＜0.05);在未漏服药组中,治疗一段时间后,如果症状消失,有3.4%的患者认为可以停止服药,在漏服药组中,则有25.0%的患者认为可以停止服药,两组差异具有统计学意义(P＝0.01).结论 抗结核药的毒副反应是导致山区涂阳肺结核患者服药依从性较低的主要原因,医生访视频次较低以及健康教育不到位可能影响患者服药意识,因此结防机构采取相应措施减少药物的毒副反应、教育病人掌握正确的处理毒副反应的措施,加强对结核病患者的健康教育以及增加督导访视频次等,这对提高患者的治疗依从性具有重要意义.

Study of treatment compliance among sputum smear-positive pulmonary tuberculosis patients in mountainous areas in Anhui Province

Objective To assess the treatment compliance and investigate factors associated with low treatment compliance in sputum smear-positive tuberculosis（TB） patients in rural,mountainous areas in Anhui Province. Methods A questionnaire survey was conducted to a random sample of 105 smear positive TB patients registered in 2007 in the 3 target counties. Results The average age of the patients was（54.02±16.37） years,77.1% of the patients were male,22.9% of the patients were female.16 patients missed medication during the course of treatment（15.2%）.In the leak medication group,50.0% of patients stopped taking anti-TB drugs or missed medication because of side effects,25.0% were due to busy with work or forgotten,and 25.0% were due to other reasons.There was significant difference in visit times of doctors between the leak medication group and no leak medication group（P0.05）.3.4% of the patients believed that the drugs could be withdrawn if symptoms disappear after a period of treatment in the no leak medication group,however,25.0% of the patients believed that the drugs could be withdrawn in the leak medication group,and the difference was significant（P=0.01）.Conclusions In these mountainous areas in AnHui Province,treatment compliance of TB patients was mainly due to toxic side effects,therefore,TB control agencies should take effective measures to reduce toxic side effects.Therefore,increasing visit times of doctors and strengthening health education about TB-related knowledge are very important for improving compliance of patients.