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目的了解北京市朝阳区肺结核患者就诊延误及确诊延误情况及影响因素,为今后防治工作提供参考。方法对2012年3~8月在朝阳区结核病门诊部初次确诊的肺结核患者进行问卷调查,应用SPSS21.0软件进行统计分析。结果因症就医患者就诊延误、确诊延误天数中位数分别为35d和11d,平均延误时间分别为35.8d和12.9d。对就诊延误有显著影响的因素分别有年龄(OR=0.692,95%CI:0.241~1.989)、文化程度(OR=0.581,95%CI:0.234~1.446)、咯血(OR=0.514,95%CI:0.196~1.350)、咳嗽(OR=0.315,95%CI:0.123~0.808)及结核病相关知识知晓情况(OR=0.116,95%CI:0.051~0.264)等(P<0.05)。对确诊延误有显著影响的因素分别有婚姻(OR=1.69,95%CI:0.560~5.099)、首诊机构(OR=1.678,95%CI:0.972~2.896)、就诊次数(OR=3.669,95%CI:0.836~16.095)及医疗费用支出(OR=32.617,95%CI:10.962~97.045)等(P<0.05)。结论北京市朝阳区肺结核患者就诊及确诊存在一定的延误情况,应加强结核病的相关知识宣教,引导人群正确的就医路径,减少多次就诊,加大对综合医院的督导工作,促进医护人员对结核病的理解,提高查痰率,树立转诊意识,健全健康体检制度以提高结核病的早期发现率。
Objective To understand the delay and diagnosis of pulmonary TB patients in Chaoyang District of Beijing and its influencing factors, and to provide reference for future prevention and treatment work. Methods A questionnaire survey of tuberculosis patients diagnosed for the first time in the outpatient department of TB in Chaoyang District from March to August 2012 was conducted and analyzed by SPSS21.0 software. Results The number of patients receiving medical treatment was delayed. The median number of days of diagnosis was 35d and 11d, respectively. The average delay time was 35.8d and 12.9d respectively. (OR = 0.581, 95% CI: 0.234-1.446), hemoptysis (OR = 0.514, 95% CI : 0.196-1.350), cough (OR = 0.315, 95% CI: 0.123-0.808), knowledge of tuberculosis (OR = 0.116, 95% CI: 0.051-0.264), etc. (P <0.05). (OR = 1.69, 95% CI: 0.560-5.099), the first visit (OR = 1.678, 95% CI: 0.972-2.896), the number of visits (OR = 3.669, 95 % CI: 0.836 ~ 16.095) and medical expenses (OR = 32.617,95% CI: 10.962 ~ 97.045) (P <0.05). Conclusions There are some delays in the diagnosis and treatment of pulmonary tuberculosis patients in Chaoyang District, Beijing. Knowledge-based TB knowledge should be strengthened to guide the correct medical treatment of the population, reduce the number of visits to hospitals, intensify the supervision of general hospitals and promote the prevention and control of tuberculosis Understanding, improve the sputum rate, establish referral awareness, improve the health examination system to improve the early detection rate of tuberculosis.