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目的了解132例晚期血吸虫病(晚血)连续6年医疗救治的情况、效果及费用,为晚血救治政策提供决策依据。方法对沙市区2003年10月经专家审核确认的132例晚血病人进行6年追踪观察,采用Excel软件分年度输入晚血病人档案,建立数据库,对资料进行统计分析。结果 132例晚血患者医疗救治前死亡22例(16.67%),实施救治110例(83.33%)。经追踪观察至2009年末,已治愈69例(52.27%);死亡31例(23.48%);10例病情不稳定,尚需进一步治疗。内科治疗91例,治愈53例,需继续治疗10例,死亡28例;外科治疗19例,治愈16例,死亡3例。内科治疗年人均费用为5000元左右,外科治疗年人均费用由2004年的7561.24元增加到2007年11724.50元。引起晚血死亡的主要原因为肝功能衰竭及上消化道大出血。结论晚血医疗救助政策的实施为患者医疗照顾提供了保障,湖北省出台的每年5000元/人救治费用的政策基本可满足项目的实施,对内科危重及外科手术病人应适当追加救治经费。连续救治后大部分晚血病人病情治愈,好转稳定,劳动力恢复,达到免费救治晚血的目的 。
Objective To understand the situation, effect and cost of 132 cases of advanced schistosomiasis (late blood) for 6 consecutive years of medical treatment, and provide a basis for decision-making on late treatment of blood. Methods Sixty-two years follow-up of 132 cases of late-blooded patients confirmed by experts in Shashi District in 2003 was conducted. Excel software was used to input the files of late blooded patients in each year, and a database was established for statistical analysis of the data. Results 132 cases of late blood died of medical treatment before the death of 22 cases (16.67%), the implementation of treatment of 110 cases (83.33%). After follow-up observation, 69 cases (52.27%) were cured by the end of 2009; 31 cases died (23.48%); 10 cases were unstable and needed further treatment. 91 cases were treated by internal medicine, 53 cases were cured, 10 cases needed continuous treatment and 28 cases died. Surgical treatment was performed in 19 cases, 16 cases were cured and 3 cases died. The average annual cost of medical treatment is about 5000 yuan, the average annual cost of surgical treatment from 7561.24 yuan in 2004 increased to 11724.50 yuan in 2007. The main causes of late blood deaths are liver failure and upper gastrointestinal bleeding. Conclusion The implementation of the late blood medical aid policy provides a guarantee for the medical care of patients. The annual policy of saving medical expenses of 5,000 yuan / person promulgated by Hubei Province can basically meet the implementation of the project, and should be properly funded and rescued for medical critical patients and surgical patients. After the continuous treatment of most patients with late bloated cured, stable and stable, labor recovery, to achieve the purpose of free treatment of late blood.