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目的调查复治肺结核既往史信息,为国家制定和调整复治肺结核患者防治政策提供依据。方法使用统一设计的调查问卷,收集2010年9月11-21日期间在北京某两家结核病专科医院经所有住院的134例复治肺结核病患者相关信息,包括患者的基本信息、首次求医行为、首次诊断和治疗等内容并进行整理分析。结果与结核病专科医院等其他机构相比,首次就诊、确诊机构及治疗都是县级以上综合医院比例最高分别为55.22%(74/134)、61.19%(82/134)及53.73%(72/134),首次检查痰涂片检出率为63.43%(85/134);首次治疗个体化方案和标准化方案分别为92.53%(124/134)及7.47%(10/134);有28.36%(38/134)的患者在治疗期间中断治疗,55.26%(21/38)的患者治疗中断原因是自认为治愈而中断治疗;35.82%(48/134)的患者发生了不良反应,因不良反应中断治疗的患者为26.32%(10/38)。结论复治肺结核患者首次就诊转诊不到位,诊疗不规范,应加强多部分合作对转诊工作进行监督,规范诊疗,加强服药监督,提高患者治疗依从性,减少治疗中断,从而减少耐药及提高治愈率。
Objective To investigate the past history of retreatment of tuberculosis and provide basis for the government to formulate and adjust the prevention and treatment policy for patients with retreatment tuberculosis. Methods A questionnaire of uniform design was used to collect information on 134 hospitalized patients with re-treatment of pulmonary tuberculosis who had been hospitalized in two TB hospitals in Beijing from September 11 to September 21, 2010, including the basic information of the patients, the first medical seeking behavior , The first diagnosis and treatment and other content and organize analysis. Results Compared with other institutions such as TB Hospital, the highest proportion of first-time referrals, diagnosed institutions and general hospitals above county level were 55.22% (74/134), 61.19% (82/134) and 53.73% (72 / 134). The detection rate of sputum smear was 63.43% (85/134) for the first time examination. The rates of individualized and standardized first treatment were 92.53% (124/134) and 7.47% (10/134), respectively. There were 28.36% 38/134) discontinued treatment during treatment, 55.26% (21/38) of patients discontinued treatment because of discontinuation of treatment; 35.82% (48/134) of patients experienced adverse reactions due to adverse reactions The treatment of patients was 26.32% (10/38). Conclusions The first visit to retreatment tuberculosis patients is not well-known and the diagnosis and treatment are not standardized. Multi-part cooperation should be strengthened to supervise the referral work, standardize diagnosis and treatment, strengthen the supervision of taking medication, improve patient compliance with treatment, reduce treatment interruption, and thus reduce drug resistance and Improve the cure rate.