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目的分析淮安市流动人口和户籍人口肺结核患者治疗管理情况,为本地区开展流动人口结核病防治工作提供参考依据。方法对2009-2014年淮安市登记管理的402例流动人口肺结核患者基本情况、临床特征、治疗转归情况进行分析,并与同期本地户籍患者进行比较。结果 2009-2014年淮安市流动人口肺结核患者中男性、年龄≤60岁患者所占比例高于本地户籍患者(74.13%vs.69.33%,χ2=4.253,P=0.039;73.63%vs.67.33%,χ2=7.085,P=0.008)。流动人口肺结核患者因症就诊比例低于本地户籍患者(20.65%vs.28.86%,χ2=12.912,P=0.000),健康检查比例高于本地户籍患者(32.09%vs.22.55%,χ2=20.198,P=0.000);就诊延迟比例高于本地户籍患者(63.93%vs.51.72%,χ2=23.380,P=0.000)。流动人口肺结核初诊伴咳嗽、咳痰症状者及痰结核分枝杆菌阳性者均高于本地户籍患者(72.14%vs.66.79%,χ2=6.385,P=0.012;31.09%vs.26.39%,χ2=4.435,P=0.035)。与本地户籍患者相比较,流动人口肺结核患者成功治疗率和系统管理率较低(89.30%vs.95.30%,χ2=30.451,P=0.000;93.78%vs.98.12%,χ2=37.572,P=0.000),治疗失败率和丢失率较高(1.99%vs.0.98%,χ2=3.978,P=0.046;4.48%vs.0.92%,χ2=49.228,P=0.000)。结论流动人口结核病患者以中青年男性为主,患者延迟就诊比例较高,成功治疗率和系统管理率低于本地户籍患者,需进一步加强流动人口肺结核患者的治疗管理工作。
Objective To analyze the treatment and management of pulmonary tuberculosis among floating population and household population in Huai’an City, and to provide a reference for carrying out tuberculosis prevention and control work among floating population in this area. Methods The basic situation, clinical characteristics and treatment outcome of 402 cases of migrant population with tuberculosis who were registered and managed in Huai’an City during 2009-2014 were analyzed and compared with those of local registered permanent residents in the same period. Results In 2009-2014, the proportion of male patients with pulmonary tuberculosis who were less than 60 years old in floating population in Huaian was higher than that of local residents (74.13% vs.69.33%, χ2 = 4.253, P = 0.039; 73.63% vs.67.33% χ2 = 7.085, P = 0.008). The proportion of migrant patients with tuberculosis was lower than that of local residents (20.65% vs.28.86%, χ2 = 12.912, P = 0.000), and the proportion of health check-ups was higher than that of local residents (32.09% vs.22.55%, χ2 = 20.198, P = 0.000). The proportion of delayed visits was higher than that of local residents (63.93% vs.51.72%, χ2 = 23.380, P = 0.000). Migratory tuberculosis patients with cough, sputum symptoms and sputum positive Mycobacterium tuberculosis were higher than those of local residents (72.14% vs.66.79%, χ2 = 6.385, P = 0.012; 31.09% vs.26.39%, χ2 = 4.435, P = 0.035). The rates of successful treatment and systematic management of migrant pulmonary tuberculosis patients were lower than those of local residents (89.30% vs.95.30%, χ2 = 30.451, P = 0.000; 93.78% vs.98.12%, χ2 = 37.572, P = 0.000 ), The treatment failure rate and loss rate were higher (1.99% vs.0.98%, χ2 = 3.978, P = 0.046; 4.48% vs.0.92%, χ2 = 49.228, P = 0.000). Conclusion The majority of migrant TB patients are young and middle-aged men, with a higher proportion of patients with delayed treatment, and successful treatment rates and system management rates lower than those of local residents. The treatment and management of migrant tuberculosis patients should be further strengthened.