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目的了解Ⅲ型结核DOTS(直接面视下短程督导治疗)治疗6个月内死亡危险因素,为提高结核病患者DOTS治疗质量和降低其治疗期间病死率提供参考。方法用Cox等比例风险模型对凯里市2005-2008年DOTS治疗6个月内死亡的Ⅲ型结核病患者有关特征及调查因素进行多因素分析。结果凯里市2005-2008年实行DOTS治疗的Ⅲ型结核病患者1507例,在治疗6个月时间内死亡31例,治疗6个月内病死率为2.1%。在所有分析的特征和因素中,年龄是Ⅲ型结核病患者在治疗6个月内死亡唯一有意义的特征,50岁以上组治疗6个月内的死亡风险高于1024岁组和2549岁组,其相对危险比分别为10.6、3.3倍。患者住址、治疗前病程、是否复治、是否伴有肺结核空洞等与其治疗期间死亡无关联。结论凯里市Ⅲ型结核病患者在DOTS治疗条件下结核病直接导致死亡的风险已降低,年龄是死亡的主要危险因素,而居住在农村、治疗前病程长、复治、伴有肺结核空洞等都不是DOTS治疗6个月内死亡的危险因素。
Objective To understand the risk factors of death in patients with DOTS (short-range superficial direct supervision by type III) treatment for 6 months and to provide references for improving the quality of DOTS and reducing the mortality during treatment. Methods Cox proportional hazards model was used to analyze the characteristics and investigation factors of type III TB patients who died of DOTS within 6 months from 2005 to 2008 in Carey City. Results A total of 1507 patients with type Ⅲ tuberculosis treated in DOTS in 2005-2008 in Kaili City died of the disease within 6 months after treatment. The mortality rate within 6 months was 2.1%. Of all the characteristics and factors analyzed, age was the only meaningful feature of death in type III TB patients within 6 months of treatment. The risk of death within 6 months of treatment over 50 years of age was higher in patients over 1024 years and 2549 years, The relative risk ratio was 10.6,3.3 times. The patient’s address, the course of treatment before treatment, whether retreatment, whether with tuberculosis and other holes were not related to the death during treatment. Conclusions The risk of death from tuberculosis has been reduced in patients with type III TB in Kaili under DOTS treatment. Age is the major risk factor for death. However, living in rural areas, long duration of treatment before treatment, retreatment and pulmonary voids are not Risk factors for death within 6 months of DOTS treatment.