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目的分析山东省乡镇查痰点工作开展情况,并针对提高查痰点工作情况提出建议。方法按地理特点采取多阶段分层抽样的方法 ,抽取8个县作为调查现场进行深入分析。采用访谈和问卷调查相结合的方式,访谈卫生局领导和乡镇卫生院院长,调查结防机构对乡镇查痰点开展的业务工作和可疑肺结核病人的基本情况。结果 2006年山东省设立乡镇查痰点497个,发现涂阳肺结核患者824例,贡献率是3.3%。调查的8个样本县共发现涂阳肺结核患者2880例,其中乡镇查痰点发现患者38例,乡镇查痰点发现涂阳肺结核患者的贡献率是1.3%。在对乡镇查痰点开展的业务工作情况方面,除几个别样本县(区)外,其余基本能够按照国家结核病防治规划的要求进行。就诊乡镇卫生院的疑似肺结核患者中有38.0%未查痰。结论山东省乡镇查痰点的设置具有一定可行性,在涂阳肺结核发现上做出一定的贡献。但存在阳性检出率较低,实验室条件较差,医务人员查痰意识不强,工作开展不平衡等问题。因此,应该结合各县(区)的具体情况,优化现有乡镇查痰点。加大领导和投入,强化业务培训,提高查痰点的工作效率。
Objective To analyze the situation of sputum spot detection in towns and villages in Shandong Province and to put forward suggestions for improving the work of sputum sampling. Methods Taking multi-stage stratified sampling method according to geographical features, 8 counties were selected as the investigation site for further analysis. Interviews and questionnaires were used to interview the leaders of Health Bureau and the head of township hospitals to investigate the work of the prevention and control agencies on the investigation of township sputum and the basic situation of suspicious TB patients. Results In 2006, 497 sputum spots were set up in towns and villages in Shandong Province. 824 smear positive pulmonary tuberculosis patients were found, accounting for 3.3% of the total. A total of 2880 cases of smear positive pulmonary tuberculosis were found in 8 sample counties in the survey, of which 38 cases were found in township sputum spotting sites and 1.3% were found smear positive tuberculosis patients in township sputum spotting sites. In the township sputum point to carry out business operations, with the exception of a few sample counties (districts), the rest can basically be in accordance with national tuberculosis prevention and control planning requirements. 38.0% of suspected pulmonary tuberculosis patients who visited the township hospitals did not check sputum. Conclusion It is feasible to set up sputum sampling sites in towns and villages in Shandong Province, and make some contribution to the discovery of smear-positive pulmonary tuberculosis. However, there is a low positive detection rate, poor laboratory conditions, medical staff awareness of sputum smelling, work imbalances and other issues. Therefore, we should combine the specific conditions of counties (districts) to optimize the existing township sputum point. Increase leadership and investment, strengthen business training, improve the efficiency of sputum point.