郴州市2003—2007年涂阳肺结核病人来源分析

目的 分析涂阳肺结核病人来源，为进一步做好郴州市涂阳肺结核病人发现工作提供科学依据。方法收集2003—2007年郴州市涂阳肺结核病人的来源资料，分析病人来源途径及其影响因素。结果2003—2007年，郴州市共发现涂阳肺结核病人11160例，其来源中就诊占37.3%,转诊占52.3%，因症推荐占9.7%，其他占0.7%；转诊所占百分率逐年上升，各年度间比较差异有统计学意义（χ²=279.8，P＜0.01）。结论医院转诊已成为郴州市涂阳病人来源的重要途径，在涂阳病人发现上占主导作用。加强结核病归口管理工作，加强医防合作，加强健康教育等是实现结控项目涂阳病人“高发现”目标的有效措施。

Analysis of the source of the smear positive tuberculosis patients in Chenzhou City from 2003 to 2007

Objective To analyze the source of the smear positive tuberculosis （TB） patients, and to provide scientific evidence for further promotion of case finding of smear positive TB patients in Chenzhou. Methods The data of the source of the smear positive TB patients from 2003 to 2007 in Chenzhou city was collected, the types of the source and the influencing factors were analyzed. Results 11600 smear positive TB patients were detected from 2003 to 2007 in Chenzhou city, among whom 37.3% was care seeking, 52.3% was referring, 9.7% was recommended because of symptom and 0.7% for other reasons. The proportion of cases from referral increased year by year, and the difference among 5 years was statistically significant （X^2 =279.8,P〈0.01）. Conclusion Referral has been an important source of the smear positive TB patients in Chenzhou city, which plays a dominant r01e in case finding of the smear positive TB patients. Strengthening TB case management, strengthening cooperation between hospital and TB control institution and promoting health education are effective measures of achievement of smear positive TB patients ＂high case detection＂.