提高农村地区新发涂阳病人发现率的探讨

目的探讨农村地区提高新涂阳肺结核病人发现率的方法和工作模式。方法随机选择不同乡镇,采取村级社区服务站直接转诊肺结核可疑者和在乡镇医院设立查痰点等干预措施,提高新涂阳肺结核病人发现率,并与常规病人发现方法对照。结果村级社区服务站直接转诊肺结核可疑者的地区,新涂阳肺结核病人登记率40.01/10万,肺结核可疑者先由乡镇医院查痰筛查的地区,新涂阳肺结核病人登记率29.11/10万,对照组新涂阳肺结核病人登记率16.27/10万,经统计学检验,有显著性差别(χ²=38.6,P<0.005)。结论通过村级社区服务站推荐、转诊肺结核可疑者和在乡镇医院开展痰涂片检查等干预措施,可有效地提高农村地区新涂阳病人发现率,同时对乡镇医院查痰点要注意加强专业人员培训和实验室建设,提高痰检质量。

Explore on increasing detection rate of new smear positive tuberculosis cases in rural areas

Objective To explore the approach of increasing detection rate of new smear positive tuberculosis cases in rural areas.Methods To utilize randomized control study,we selected randomly 6 townships in Hai’an county and divided randomly into 2 groups.Different intervention approach was carried out in the 2 groups.The other 8 townships were composed to control group.Results The new smear positive rate was 40/100000 in intervention group 1 that carried out referral management at countryside community health service station.The rate was 29.1/100000 in intervention group 2 that carried out sputum examinatioqn in township village smear clinic.The rate was 16.3/100000 in control group（χ²=38.6,P<0.0001）.Conclusion Strengthening referral management at countryside community health service station and carrying out sputum examination in township smear exemination sites could all increase the detection rate of new smear positive.But the staffs training,laboratory building and examination quality control of sputum examination sites in township village need to be enhanced.