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目的探讨乡镇卫生院发现可疑肺结核病人存在的缺失,改善结核病控制策略和工作方法,提高病人的发现水平。方法调查卫生院影像学诊断现状和疑似肺结核病人发现现状,结合对日常督导情况,探讨可疑病人发现方面存在的问题。结果全市123个卫生院,有112个(91%)拥有100 mA以上的X光机。拥有X光机的卫生院中,专职放射人员占40.2%,兼职者占34.8%,有25.0%无放射人员;绝大多数卫生院放射人员由初、中级临床医师转行执业;2010年1～7月全市14个卫生院的可疑肺结核病人发现106例,网报率66%,转诊率69.8%,与规定指标差距甚大。结论为有效控制结核病,必须提高卫生院医务人员素质、结核意识和病人发现能力。
Objective To explore the existing problems of township hospitals in finding suspicious pulmonary tuberculosis patients, to improve tuberculosis control strategies and working methods, and to improve the level of patient discovery. Methods To investigate the status of imaging diagnosis in hospitals and the status quo of suspected tuberculosis patients, and to explore the problems in the detection of suspicious patients in combination with the routine supervision. Results The city’s 123 hospitals, 112 (91%) have more than 100 mA X-ray machine. Among the hospitals with X-ray machines, 40.2% were full-time radiologists, 34.8% were part-time radiologists, and 25.0% were non-radiologists. Most radiologists in hospitals were transferred from primary and secondary clinicians to practitioners. In 2010, 1 to 7 106 suspicious tuberculosis cases were found in 14 hospitals in the whole city on month, with a net report rate of 66% and a referral rate of 69.8%, which was far from the prescribed target. Conclusion In order to effectively control tuberculosis, it is necessary to improve the quality of medical personnel in hospitals, tuberculosis awareness and patient discovery ability.