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目的探讨如何通过干预措施(对医务人员进行结核相关知识培训)提高综合医院临床肺结核发现率。方法采取前瞻性研究。对比观察经培训医院自身在培训前后呼吸科医师对肺结核的诊断意识及肺结核发现情况并对比观察同期经培训与未经培训医院呼吸科医师对肺结核的诊断意识及肺结核发现情况。结果观察医院培训前后6个月观察项目自身对照在肺结核报卡率、报卡菌阳率、报卡痰检菌阳率、报卡痰检率和患者来源均无统计学意义,肺结核报卡率在培训后第1个月最高,较其它月份有显著统计学意义(χ2=7.02,P=0.00805,P<0.01)。观察医院培训后与对照医院同期比较,在呼吸科拍片率、肺结核报卡率、报卡菌阳率和报卡痰检率均有提高,具有统计学差异(P<0.05)。结论短期培训不能达到预期效果,应完善医院自身的传染病管理系统,形成长效机制,以达到对肺结核可疑者进行早期筛查,减少漏诊。
Objective To explore how to improve clinical tuberculosis detection rate in general hospitals by means of interventions (training of medical staff on TB related knowledge). Methods To take a prospective study. The contrastive observation was made between the trained physicians’ awareness of the diagnosis of tuberculosis and the detection of tuberculosis before and after training. The contrastive observation was made between the awareness of tuberculosis diagnosis and the detection of pulmonary tuberculosis among the trained and untreated hospital respiratory doctors during the same period. Results Observation of hospital self-control 6 months before and after training in the project reporting rate of pulmonary tuberculosis, positive card positivity, card sputum test positive rate, card sputum examination rate and source of patients were not statistically significant, the rate of reported tuberculosis The first month after training was the highest, which was statistically significant compared with the other months (χ2 = 7.02, P = 0.00805, P <0.01). Observation hospital training compared with the control hospital over the same period, in the respiratory section film rate, reported rate of pulmonary tuberculosis, positive card positivity and card sputum examination rate has increased, with statistical differences (P <0.05). Conclusion Short-term training can not achieve the expected results. The hospital’s own infectious disease management system should be improved and a long-term mechanism should be established to achieve early screening of suspected tuberculosis patients and reduce missed diagnosis.