影响肺结核治愈的原因分析与探讨

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目的分析影响肺结核患者治愈的因素,为提高肺结核治愈率提供依据。方法收集2007~2012年甘肃省民乐县新涂阳肺结核患者治愈情况的相关信息并进行调查分析。结果共调查新涂阳患者490例,治愈393例,治愈率80.2%,半年后复发97例,复发率19.8%;复发组在就诊前结核病防治知识知晓率(55.7%)低于治愈组(76.0%);复发组接受综合医院治疗大于1个月者比率(18.5%),明显高于治愈组(6.3%);复发组及时转诊(7日内)到位率(14.4%),明显低于治愈组(93.6%);复发组患者规则治疗依从性比率(5.3%)明显低于治愈组(79.2%)。结论患者对结核病防治知识知晓率、病后及时转诊到位率、接受规范治疗率低是影响肺结核治愈的主要原因,应加强宣传力度,建立健全转诊审批制度,强化督导管理,给予结核病患者早期、及时、全程、规范的治疗,提高治愈率。 Objective To analyze the factors influencing the cure of patients with pulmonary tuberculosis and provide basis for improving the cure rate of pulmonary tuberculosis. Methods The related information about the cure of patients with newly smear positive pulmonary tuberculosis in Minle County of Gansu Province from 2007 to 2012 was collected and analyzed. Results A total of 490 cases of newly smear positive patients were cured, 393 cases were cured, the cure rate was 80.2%, and 97 cases relapsed after half a year, the recurrence rate was 19.8%. The awareness rate of tuberculosis control in the recurrence group was 55.7% %). The proportion of patients who received general hospital treatment for more than one month in the recurrence group was significantly higher than that in the cured group (18.5% vs 6.3%), and the prompt referral rate (14.4%) in the recurrence group was significantly lower than that of the cure group (93.6%). The rule-based treatment compliance rate (5.3%) in the relapse group was significantly lower than that in the cure group (79.2%). Conclusions The patients’ knowledge of tuberculosis prevention and treatment, timely referral of patients after TBI, and low standardized treatment rate are the main reasons that affect tuberculosis cure. Publicity efforts should be strengthened to establish and improve the referral examination and approval system, to strengthen supervision and management and to give tuberculosis patients early , Timely, full, standardized treatment, improve the cure rate.
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