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目的分析2002—2013年广西肺结核病疫情态势,评价广西结核病发现工作质量。方法利用2002—2013年广西结核病网络专报系统及对容县、兴业县、富川县、昭平县、苍梧县、藤县等6县结核病防治工作现场督导资料,统计分析各年活动性肺结核登记率、新涂阳登记率及其占同期活动性肺结核登记率的比例和各年发现率,现场抽检6县结核患者痰检率、痰检阳性率、痰检合格率等,采用SPSS 19.0统计软件进行统计,应用CoxStuart显著性检验进行变化趋势的统计学处理,分析疫情变化趋势及原因。结果 2004—2013年活动性肺结核患者登记率呈下降趋势,新涂阳患者登记率无升降趋势;新涂阳肺结核患者占活动性肺结核的比例范围为22.75%~37.00%,无升降趋势;各年新涂阳发现率无升降趋势。2011—2013年,活动性肺结核患者登记率年均下降3.7%,新涂阳患者登记率年均下降24.4%;新涂阳肺结核患者占活动性肺结核的比例范围年均递降21.58%;新涂阳发现率年均递降24.4%;新涂阳患者构成比年均递降1.3%,复治涂阳患者构成比年均递升13.9%。6县总痰检率为72.62%,痰涂片不合格率44.94%,初诊涂阳患者检出率为7.96%。结论 2004—2013年广西活动性肺结核疫情持续缓慢下降,但10年来新涂阳疫情依旧。2011年以来,新涂阳患者发现急剧下滑,下行压力加大,治疗管理质量滑坡。对结核病防控行政推动减弱,对痰涂片检查工作督查不力,是导致质量下降的主因。
Objective To analyze the epidemic situation of pulmonary tuberculosis in Guangxi from 2002 to 2013 and evaluate the quality of tuberculosis discovery in Guangxi. Methods By using Guangxi TB Network Special Report System from 2002 to 2013 and field surveillance data of tuberculosis control in 6 counties including Rongxian, Xingye, Fuchuan, Zhaoping, Cangwu and Tengxian, statistical analysis was made on active tuberculosis registration Rate, registration rate of new smear and its proportion in active registration rate of tuberculosis in the same period and its incidence in each year, sputum sampling rate in 6 county tuberculosis patients, the positive rate of sputum examination and the passing rate of sputum examination on the spot, SPSS 19.0 statistical software Statistical analysis was made. The statistical analysis was made by using CoxStuart significance test to analyze the trends and causes of epidemic situation. Results The registration rate of patients with active pulmonary tuberculosis decreased from 2004 to 2013, and the registration rate of new smear-positive patients showed no upward trend. The proportion of newly smear-positive pulmonary tuberculosis among active pulmonary tuberculosis ranged from 22.75% to 37.00% The new smear found no upward trend. From 2011 to 2013, the registration rate of active tuberculosis patients decreased by 3.7% annually, while the registration rate of new smear-positive patients decreased by 24.4% annually. The proportion of newly smear-positive tuberculosis patients with active tuberculosis decreased by an average of 21.58% The average annual rate of decrease was 24.4%. The composition of newly smear positive patients decreased by 1.3% compared with that of the average year, and the proportion of patients receiving retreatment and smearing positive was 13.9% higher than the average. 6 counties sputum examination rate was 72.62%, smear failed 44.94%, newly diagnosed smear positive rate was 7.96%. Conclusion The epidemic situation of active pulmonary tuberculosis in Guangxi continued to decline slowly from 2004 to 2013, but the epidemic situation of new smear of smear in 10 years remains the same. Since 2011, the new smear-positive patients have found a sharp decline, downward pressure on the quality of treatment and management decline. The prevention and control of tuberculosis to promote administrative weakening, inspection of sputum smear inspection ineffective, is the main cause of the decline in quality.