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目的 分析深圳市肺结核患者电子网络督导管理情况,为进一步完善结核病管理模式提供科学依据.方法 以2012-2015年深圳市电子网络督导管理系统(TBEDOTS)中全程在深圳治疗管理的14 129例活动性肺结核患者为研究对象,分析不同年份和不同户籍类型间肺结核患者的服药率、不良反应发生率和治疗转归等情况.结果 2012-2015年TBEDOTS纳入患者管理率从85.77％(3658/4265)提高到99.61％(3808/3823),刷卡服药率从65.26％(409 800/627 960)提高至75.94％(492 108/648 060),异点服药率47.85％(1634/3415)提高至87.97％(3137/3566),请假确认服药率从94.40％(163 920/173 650)上升至99.54％(150 035/150 725),漏服药率从8.64％(54 240/627 960)下降至0.91％(5917/648 060),差异均有统计学意义(x2趋势=858.48,P=0.000;x2趋势=18 276.24,P=0.000;x2趋势=1480.55,P=0.000;x2趋势=7716.74,P=0.000;x2趋势=44 486.59,P=0.000).深圳户籍肺结核患者的刷卡服药率和请假确认服药率分别为75.18％(139 826/186 000)、98.31％(39 542/40 221),明显高于非深圳户籍患者[71.14％(1 705 502/2 397 480)、96.55％(570 481/590 883)],差异有统计学意义(x2=1379.06,P=0.000;x2=363.18,P=0.000);深圳户籍患者的漏服药率和异点服药率分别为3.57％(6632/186 000)、34.15％(347/1016),明显低于非深圳户籍患者[5.07％(121 497/2 397 480)、76.52％(10 034/13 113)],差异有统计学意义(x2 =826.25,P=0.000;x2=868.36,P=0.000).深圳户籍患者的治疗成功率(93.60％,951/1016)略高于非深圳户籍患者(91.83％,12 042/13 113),深圳户籍患者的丢失率(0.49％,5/1016)明显低于非深圳户籍患者(2.55％,334/13 113),差异均有统计学意义(x2=4.00,P=0.046;x2 =17.00,P=0.000).结论 深圳市应用电子网络督导管理系统取得较好的管治效果,不仅方便了肺结核患者的督导服药,而且提高了管理效率,但仍有改善空间.“,”Objective To analyze the managing treatment of tuberculosis based on the electronic network supervision management system (TBEDOTS),in order to provide evidences to improve TB management.Methods Data of 14 129 TB cases registered in Shenzhen between 2012 and 2015 were obtained from TBEDOTS.The rates of guided medication,adverse reactions and treatment effect of TB patients with different years and household registers were analyzed.Results The rate of TB patients who were integrated into the electronic network supervision management system had increased from 85.77％ (3658/4265) in 2012 to 99.61％ (3808/3823) in 2015 (x2trend =858.48,P=0.000),the rate of patients who swiped card and took medication had increased from 65.26％ (409 800/627 960) in 2012 to 75.94％ (492 108/648 060) in 2015 (x2trend =18 276.24,P=0.000),the rate of patients who took medicine in other supervision sites had increased from 47.85％ (1634/3415) in 2012 to 87.97％ (3137/3566) in 2015 (x2trend =1480.55,P=0.000),the rate of patients who asked for leave and confirmed taking the medication was increased from 94.40％ (163 920/173 650) in 2012 to 99.54％ (150 035/150 725) in 2015 (x2trend =7716.54,P=0.000),the rate of patients who missed medication was decreased from 8.64％ (54 240/627 960) in 2012 to 0.91％ (5917/648 060) in 2015 (x2trend =44 486.59,P=0.000),the rate of local patients who swiped card and took medication and the rate of local patients who asked for leave and confirmed taking the medication (75.18％(139 826/186 000) and 98.31％ (39 542/40 221)) was significantly higher than those of migrant patients (71.14％(1 705 502/2 397 480) and 96.55％ (570 481/590 883)) (x2 =1379.06,P=0.000;x2 =363.18,P=0.000).The rate of local patients who missed medication and the rate of local patients who took medicine in other supervision sites (3.57％ (6632/186 000);34.15％ (347/1016)) were significantly lower than those of migrant patients (5.07％ (121 497/2 397 480);76.52％ (10 034/13 113) (x2 =826.25,P=0.000;x2 =868.36,P=0.000).The treatment success rate of local patients (93.60％,951/1016) was a litter higher than that of migrant patients (91.83％,12 042/13 113)(x2 =4.00,P=0.046),while the loss rate of local patients (0.49％,5/1016) was significantly lower than that of migrant patients (2.55％,334/13 113) (x2 =17.00,P-0.000).Conclusion The managing treatment of tuberculosis based on the electronic network supervision management system is good,which not only benefit patients for taking the medication,but also improve management efficiency.However,it still need more improvement.