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目的了解乌鲁木齐市耐多药肺结核防治工作、控制策略及存在问题,为制定耐多药肺结核预防控制策略提供依据。方法采用非结构式面对面个人访谈方法,选取乌鲁木齐市疾病预防控制中心和结核病防治定点医院主要负责人和市卫生计生局分管结核病防治的负责人共5人进行访谈,内容包括乌鲁木齐市耐多药肺结核患者诊疗与服药现状、患者依从性与经济负担、社会影响因素、卫生资源配置及管理模式与政策等,由新疆医科大学相关专家和乌鲁木齐市疾病预防控制中心结核病防治科人员对访谈内容进行汇总分析。结果访谈对象表示,乌鲁木齐市耐多药肺结核患者收治及时,延迟较少,转诊到位率高;除严重不良反应及流动人口外,其他耐多药肺结核患者治疗依从性较高;定点医院基本不使用二线药物,多数患者无经济负担,但有严重并发症、重症或广泛耐药的患者经济负担较重;流动人口问题和歧视问题是目前最主要的社会影响因素;乌鲁木齐市结核病防治机构设备完善,政府资金投入充足,但人员配备不足;惠民政策的实施对乌鲁木齐市结核病防治工作起到推动作用。结论加强耐多药肺结核知识的健康教育和对危重患者的扶持力度,积极推广家庭督导模式应作为乌鲁木齐市耐多药肺结核防治工作的重点。
Objective To understand the prevention and control of MDR-TB in Urumqi, the control strategies and existing problems, and provide evidence for the development of multi-drug-resistant tuberculosis prevention and control strategies. Methods A non-structured face-to-face interview was conducted to interview five persons in charge of Urumqi Center for Disease Control and Prevention and the designated hospital for tuberculosis prevention and control and the person in charge of prevention and control of tuberculosis in the Municipal Health and Family Planning Bureau. The interview included Urumqi patients with multidrug-resistant tuberculosis The current situation of diagnosis and treatment, patient compliance and economic burden, social influence factors, allocation of health resources and management modes and policies, the experts from Xinjiang Medical University and Urumqi Municipal Center for Disease Control and Prevention TB prevention and treatment of the content of the interview were summarized. Results The interviewees indicated that patients with MDR-TB in Urumqi were treated promptly and with less delay and the referral rate was high. In addition to serious adverse reactions and floating population, other MDR-TB patients were treated with higher adherence; Most patients have no financial burden to use second-line drugs. However, patients with severe complications and severe or extensive drug resistance have a heavy financial burden. Floating population and discrimination are the most important social factors at present. Urumqi TB control facilities are well equipped , Sufficient government funding, but inadequate staffing; implementation of the Huimin policy to promote prevention and treatment of tuberculosis in Urumqi. Conclusion Strengthening health education of multidrug-resistant pulmonary tuberculosis and supporting the critically ill patients and actively promoting home supervision should be the focus of multidrug-resistant tuberculosis prevention and control work in Urumqi.