论文部分内容阅读
欲控制结核病的流行,首先须控制结核病传染源,化学疗法是控制结核病传染源的有效措施。然而,在结核病防治工作中,由于病人不能坚持足够长时间的用药,常常造成治疗失败,使结核病的流行:不能得到控制。我们通过调查本市两个县1976、1977年新发现肺结核病人坚持服药情况发现,能坚持半年用药者为55.4％,坚持一年用药者仅为38.3％。初治排菌病人一年痰菌阴转率仅为44.1％。由于初治失败,势必造成大量的慢性传染源。我们调查本市部分农村地区登记的肺结核病人中,慢性传染源占总登记传染源的77.3％,其中大多数病人(77.3％)在初冶阶段中断治疗和不规律用药。在调查不能坚持用药的原因中,仅有21.3％是因经济困难,而75％是因缺乏防治管理措施。以上情况反映在农村结核病防治工作中,落实“查出必治、治必彻底”存在着严重问题。因此,为了有效地控制结核病的流行,控制结核病传染源,保证病人坚持规律用药已成为结核病防治工作急需优先解决的关键问题。我们于1978年初开始探索在一个县的范围内,为落实农村新发现肺结核病人的彻底治疗工作,采用不住院全面监督化学疗法,即肺结核病人每次用药须在医务人员直接掌握下使㈩,如病人未按规定用药,则及时采取补救措施,以保证病人坚持用药、迄今一年多以来,初步获得成功。
To control the epidemic of tuberculosis, we must first control the source of tuberculosis and chemotherapy is an effective measure to control the source of tuberculosis. However, in tuberculosis prevention and treatment, the failure of treatment to succeed because of the inability of patients to adhere to medication for a long time can make the epidemic of tuberculosis unmanageable. We investigated the newly discovered cases of tuberculosis patients in two counties in 1976 and 1977 in our city and found that 55.4% of those who could insist on half a year of medication and only 38.3% of those who insisted on one year of medication. The first year of row bacteria bacteria sputum negative conversion rate was only 44.1%. As a result of the initial treatment failed, it is bound to cause a lot of chronic infection. We surveyed 77.3% of TB patients registered in some rural areas of the municipality as chronic infectious diseases, and most of them (77.3%) discontinued treatment and irregular medication during the initial stages of metallurgy. Of the reasons why we can not insist on drug use, only 21.3% were due to financial hardship and 75% were lack of prevention and control measures. The above situation is reflected in the work of prevention and treatment of tuberculosis in rural areas, and the implementation of the principle of “detecting all cases of diseases must be thoroughly implemented” has serious problems. Therefore, in order to effectively control the epidemic of tuberculosis, control the source of tuberculosis and ensure that patients adhere to regular medication, it has become a key issue urgently needed to be solved in tuberculosis prevention and control work urgently. We started to explore in a county in the early 1978 to implement the thorough treatment of newly discovered tuberculosis patients in rural areas and to adopt the principle of non-hospital full supervision of chemotherapy. That is, each time a patient with tuberculosis should be treated directly by the medical staff, If the patient fails to take the prescribed medication, timely remedial measures will be taken to ensure that the patient persists in using the drug. For more than a year now, initial success has been achieved.