论文部分内容阅读
目的:调查肺结核病的诊断和在结核病人完成疗程以前医生决定停止治疗的相关因素。设计:调查台湾地区台北市所有居民医疗档案中,在2003年已经接受治疗的肺结核病人。结果:1 126例肺结核病人中,512例(45.5%)仅根据胸部X线检查结果立即开始治疗,214例(19.0%)基于痰涂片检查发现抗酸杆菌阳性进行治疗,261例(23.2%)基于其他检查结果,还有139例(12.3%)根据细菌培养阳性的结果。在1126例肺结核患者中,156例(13.9%)被临床医生改变了结核病的诊断。多因素分析显示,仅依靠X光胸片或其他方法、女性病人、中断治疗2个月的病人、在其他卫生机构(转诊)继续治疗的病人以及肺癌病人与其他组相比有更大的改变诊断可能性。结论:有一部分的病人基于单独的胸部X线检查结果给予抗结核治疗,其中相当比例在完成结核病治疗全疗程前被医生劝告停止治疗,调查表明对台湾结核病控制项目需要尽快引起关注。
PURPOSE: To investigate the diagnosis of tuberculosis and the related factors by which the doctor decided to discontinue treatment before the TB patient completed the course of treatment. Design: To investigate the TB files of all residents in Taiwan Taipei who have been treated in 2003. RESULTS: Of the 126 cases of tuberculosis, 512 (45.5%) started treatment immediately based on chest X-ray findings, 214 (19.0%) were positive for acid-fast bacilli on the basis of sputum smear and 261 (23.2% ) Based on other test results, 139 (12.3%) were based on positive bacterial culture results. Of the 1126 tuberculosis patients, 156 (13.9%) were diagnosed with tuberculosis by their clinician. Multivariate analysis showed that female patients, patients who discontinued treatment for 2 months alone, patients who continued treatment at other health facilities (referral), and lung cancer patients had larger Change the diagnostic possibilities. CONCLUSIONS: A proportion of patients were given anti-TB treatment on the basis of a single chest X-ray examination. A considerable proportion of them were advised by doctors to discontinue treatment before completing the full TB treatment. Investigations indicate that TB control programs in Taiwan need to receive immediate attention.