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目的了解网络直报后实施的管理措施对乙肝诊断报告的影响。方法采用描述流行病学方法,对2004-2013年《中国疾病预防控制信息系统》终审报告的乙肝病例的发病趋势、分类、实验室确诊等情况进行分析,对天津实施措施前后和国家同期比较,分析指标变化情况。结果网络直报初期天津与国家发病趋势一致(t=1.00,P=0.421),均上升,建立报告标准后天津发病趋势改变(x2趋势=924.84,P<0.001),与国家趋势不同(t=9.74,P<0.001);统一标准后发病数(率)下降的主要以慢性乙肝为主;通过设立肝炎监测点能够提高乙肝分类率、实验室诊断率和肝炎分型率等主要诊断指标质量。结论设立肝炎监测点能够提高乙肝诊断和报告质量,制定明确统一的乙肝报告标准是结束混乱报告及保证连续监测有效的根本措施。
Objective To understand the impact of the implementation of management measures on the diagnosis of hepatitis B after the network direct reporting. Methods Descriptive epidemiological methods were used to analyze the incidence trend, classification and laboratory diagnosis of hepatitis B cases from the final report of China Disease Prevention and Control Information System from 2004 to 2013. Compared with the same period in Tianjin before and after the implementation of the measures, Analyze the changes of indicators. Results In the early stage of internet direct reporting, the trend of incidence in Tianjin was the same as that of the country (t = 1.00, P = 0.421), both of them increased. After the establishment of the reporting standard, the trend of incidence in Tianjin changed (x2 trend = 924.84, 9.74, P <0.001). The incidence of chronic hepatitis B was mainly decreased after the standardization of the incidence (percentage); the quality of major diagnostic indicators such as hepatitis B classification rate, laboratory diagnosis rate and hepatitis typing rate could be improved by establishing hepatitis monitoring points. Conclusion The establishment of hepatitis monitoring points can improve the diagnosis and reporting of hepatitis B. The establishment of a clear and uniform reporting standard of hepatitis B is the fundamental measure to end the report of chaos and ensure continuous monitoring.