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目的分析学生结核病聚集性感染的影响因素,为学校肺结核病防控提供依据。方法对出现病例所有班级学生进行胸透检查、X线胸部摄片,部分班级开展结核菌素(PPD)试验,对X线胸片检查异常者给予痰涂片检查,查抗酸杆菌。结果此次共发现肺结核病26例,首发病例被误诊为慢性咽炎3个多月,首发病例所在班级、寝室均有明显的聚集现象,P<0.01。在筛查中胸透肺结核病发现率为0.10%,PPD试验结合X线胸片检查,发现率为40.48%。结论首发病例被误诊后没有及时隔离治疗,是造成本次聚集性感染的主要原因。加强学校对传染病的管理,建立学生及教师因病缺课登记及病因追踪登记制度,建立医院、学校、疾病预防控制中心为一体的防控网络,是预防学校肺结核病聚集性感染的有效方法 。
Objective To analyze the influencing factors of tuberculosis infection among students and provide basis for prevention and control of tuberculosis in school. Methods Thoracic examination, X-ray chest radiography, and some classes of tuberculin (PPD) test were performed on all the students in all the cases. Sputum smear tests and acid-fast bacilli were performed on those with abnormal chest X-ray examination. Results A total of 26 cases of pulmonary tuberculosis were found. The first case was misdiagnosed as chronic pharyngitis for more than 3 months. The first case had obvious aggregation in the classroom and the sleeping room (P <0.01). The detection rate of chest X-ray tuberculosis was 0.10%. The PPD test combined with X-ray examination revealed a rate of 40.48%. Conclusion The first case was misdiagnosed without timely isolation and treatment, is the main cause of this cluster of infections. Strengthening the management of infectious diseases in schools, setting up student and teacher registration systems for registration of absences due to illness and etiological tracking registration system, and establishing prevention and control networks integrating hospitals, schools and CDCs are effective ways to prevent cluster infection of tuberculosis in schools .