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目的了解淮安市2010—2013年报告的病毒性肝炎是否与血清学诊断相符合,掌握诊断报告质量。方法按县区随机在该辖区内的一级、二级及以上医疗机构采集确诊病毒性肝炎病例的血清,在实验室检测核对后比较诊断的符合率。结果病毒性肝炎总的诊断符合率为71.92%,其中乙型肝炎(乙肝)的符合率最高,为91.83%;甲型肝炎(甲肝)的符合率最低,为13.19%;甲肝的诊断符合率在二级及以上的医疗机构和一级医疗机构中存在差别(Fisher确切概率法,P<0.01);肝炎合并感染病例的完整报告率为20.37%;以抗-Hbc IgM为参考指标,乙肝急慢性的判断与临床医生报告的型别差异有统计学意义(χ~2=16.62,P<0.05)。结论淮安市病毒性肝炎的血清学诊断符合率较低,应加强医疗机构传染病诊断标准、报告方面的培训,强化临床医生的责任心,确保疫情信息的准确。
Objective To understand whether the reported viral hepatitis in 2010-2013 in Huaian is consistent with serological diagnosis and to master the quality of diagnostic reports. Methods The serums of the confirmed cases of viral hepatitis were collected randomly by the first, the second and the above medical institutions in the county according to the county area, and the coincidence rate of the diagnosis was compared in the laboratory after the test. Results The overall diagnostic coincidence rate of viral hepatitis was 71.92%, of which the coincidence rate of hepatitis B (hepatitis B) was the highest, 91.83%; the coincidence rate of hepatitis A (hepatitis A) was the lowest, at 13.19%; the diagnostic coincidence rate of hepatitis A (Fisher exact test, P <0.01). The complete report rate of hepatitis co-infection was 20.37%. The anti-HBc IgM was used as the reference index, the acute and chronic hepatitis B There was a statistically significant difference between the type of judgment and that reported by clinicians (χ ~ 2 = 16.62, P <0.05). Conclusions The coincidence rate of serological diagnosis of viral hepatitis in Huai’an City is relatively low. Diagnostic criteria and reporting training of infectious diseases in medical institutions should be strengthened to enhance clinicians’ responsibility and ensure the accuracy of epidemic information.