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目的分析深圳市梅毒报告病例诊断的准确性和规范治疗情况,为进一步改进梅毒监测和防治工作提供依据。方法从中国疾病预防控制信息系统中,导出2013年7月1日至2014年6月30日,深圳市各医疗机构网络报告的梅毒病例。采用抽样调查方式,由专业人员将之与医疗机构的门诊日志、实验室检测结果、药房处方等进行核对,按国家梅毒诊断标准和治疗指南,评估报告病例是否准确诊断和规范治疗。结果共调查梅毒报告病例1589例,分期正确率为95.53%(1518例)。其中一期梅毒正确率为83.59%(163/195),二期梅毒为96.60%(341/353),三期梅毒为97.73%(43/44),胎传梅毒为100.00%(19/19),隐性梅毒为97.34%(952/978)。规范治疗率为67.84%(1078/1589),其中青霉素药物治疗率为66.08%(1050/1589),替代药物治疗率为1.76%(28/1589)。结论深圳市梅毒诊断准确率较高,但规范治疗率低于国家要求,应进一步加强培训和督导,完善传染病报告卡梅毒诊疗信息的填写,提高梅毒诊断准确率和规范治疗率。
Objective To analyze the accuracy of diagnosis and standardized treatment of syphilis in Shenzhen and to provide basis for further improvement of syphilis surveillance and prevention. Methods The syphilis cases reported from the network of Shenzhen medical institutions from July 1, 2013 to June 30, 2014 were derived from China’s disease control and prevention information system. By means of sample survey, professionals check with outpatient clinics, laboratory test results and pharmacy prescriptions by medical professionals to assess whether the cases are accurately diagnosed and standardized according to the national diagnostic criteria for syphilis and treatment guidelines. Results A total of 1589 cases of syphilis were reported. The staging accuracy was 95.53% (1518 cases). The correct rate of syphilis was 83.59% (163/195), secondary syphilis was 96.60% (341/353), tertiary syphilis was 97.73% (43/44) and fetal syphilis was 100.00% (19/19) , Recessive syphilis was 97.34% (952/978). The standard treatment rate was 67.84% (1078/1589), of which penicillin drug treatment rate was 66.08% (1050/1589), alternative drug treatment rate was 1.76% (28/1589). Conclusions The accuracy rate of syphilis diagnosis in Shenzhen is high, but the standard treatment rate is lower than the national requirements. The training and supervision should be further strengthened to fill in the information of syphilis diagnosis and treatment of infectious diseases and to improve the diagnostic accuracy rate and standard treatment rate of syphilis.