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目的探讨北京市大学新生实施PPD监测及对其中PPD反应硬结≥15mm者实施免费拍摄X线胸片检查和采取预防性治疗的必要性、可行性。方法对北京西城区三所大学自2004-2011年8年间入学新生做PPD试验,PPD反应≥15mm者摄胸部X线片并动员结核病预防性治疗,方案:3H2L2。结果 8年间共有新生14 833人,PPD试验人数14 504人,复验人数14 010人(占PPD试验人数的96.59%)。PPD反应≥15mm者1 689人(12.06%),全部摄胸部X线片,检出活动性肺结核病人4人(其中3人入学体验时已发现肺部病变),实际仅检出1人,活动性肺结核检出率(0.06%)。105人(6.22%)同意接受预防性治疗,但仅51人(48.57%)完成治疗。全部学生在校期间未发现肺及肺外结核病。为检出这名病人实际花费291 095.49元。结论北京市大学入学新生实施PPD监测及预防性治疗措施耗资巨大而无实效,不太符合费用/效益原则决策者应进一步调查研究以审核该项措施的可行性。
Objective To investigate the feasibility and feasibility of using freshmen of Beijing University to carry out PPD monitoring and to carry out free radiographs of X-ray and preventive treatment for patients with PPD reactive induration. Methods The PPD test was performed on three freshmen from Xicheng District in Beijing during the eight years from 2004 to 2011. The patients with PPD ≥15mm were asked to take chest X - ray and mobilize the preventive treatment of tuberculosis. The protocol was 3H2L2. Results A total of 14 833 newborn students were enrolled during the 8 years. There were 14 504 PPD trials and 14 010 retestings (accounting for 96.59% of the total number of PPD trials). 1 689 (12.06%) patients with PPD ≥15 mm were examined by X-ray of chest X-ray. Four patients with active pulmonary tuberculosis were detected (three of them had lung lesions when they were enrolled in the study), only one person was actually detected. The detection rate of tuberculosis (0.06%). 105 (6.22%) agreed to receive prophylactic treatment, but only 51 (48.57%) completed the treatment. All students found no pulmonary and extra-pulmonary tuberculosis during their schooling. In order to check out this patient actually spent 291 095.49 yuan. Conclusions The measures taken by Beijing University Entrance Freshmen to implement PPD monitoring and prophylactic treatment are costly and ineffective, which are not in line with the principle of cost / benefit. Decision makers should further investigate and study the feasibility of this measure.