陆群 胡烛燃 孙红专 钱耀忠 张静

摘 要 目的：分析奉贤区综合医院在结核患者发现中的作用以及网络报告肺结核患者追踪不到位的原因。方法：对奉贤区3所综合医院2009年1月～2011年12月传染病网络直报系统上报的疑似肺结核患者报告卡资料和同期结核病疫情登记管理卡、结核患者初诊登记本，疫情追踪登记本等相关资料进行统计分析。结果：奉贤区综合医院传（直）报疑/确诊肺结核患者1 040例，占辖区内各医疗机构传（直）报总数73.6％，1 040例患者中确诊涂阳肺结核患者150例，占辖区内各医疗机构传报确诊涂阳肺结核患者总数72.5％。总体到位的885例，到位率85.0％；不到位的155例，不到位率15.0％。追踪不到位的因素有返乡85例，占8.2％；查无此人30例，占2.9％；地址不详18例，占1.7％；其他16例，占1.5％；死亡4例，占0.4％；拒绝就诊2例，占0.2％。结论：综合医院是发现肺结核患者的重要来源。提高网络直报资料的准确性和加强流动人口管理是提高肺结核患者追踪到位率的重要措施。

关键词医院肺结核预防和控制

中图分类号：R521文献标识码：A文章编号：1006-1533（2012）12-0040-03

Survey on Fengxian polyclinic internet data of pulmonary tuberculosis

patients not be traced and verified

LU Qun1, HU Zhu-ran1, SUN Hong-zhuan1, QIAN Yao-zhong1, ZHANG Jin2

(1. Fengxian Center for Disease Control and Prevention, Shanghai, 201400; 2. Fengxian Guhua Hospital, Shanghai, 201400 )

ABSTRACTObjective: Analysis of the function of Fengxian polyclinic about discovering pulmonary tuberculosis, and factors that result to internet data of pulmonary tuberculosis patients not be traced and verified. Method: Collect the number of people who are suspected of diagnosed as pulmonary tuberculosis, which transmited through internet from Jan of 08 to Dec of 10, make analysis to the records of first consultation and some correlative data. Results: The number of people suspected of /diagnosed as tuberculosis is 1040 which occupy 73.6% from total number transmited by whole meidical institutions affiliated in the popedom. Thereinto 150 cases are diagnosed as smear positive pulmonary tuberculosis, which occupy 72.5% in total number of smear positive pulmonary tuberculosis transmitted on the Web from whole meidical institutions in the popedom. Verified case is 885, of which the rate is 85%; unverified case is 150, of which the rate is 15%. The reason for 85 cases of unverified patients information is due to returning back home, which accounts for 8.2%; 30cases are due to no body found by the name, which accounts for 2.9%; 18 cases for incorrected address accounts for 1.7%; death numbers are 4 cases accounting for 0.4%; there are two cases refusing to see a doctor accounting for 0.2%; others are 16 cases accounting for 1.5%. Conclusion: Patient with pulmonary tuberculosis is mainly discovered by polyclinic. There are many factors that result in inability to verify to information of pulmonary tuberculosis patients. Hereinto, returning back home, no body found by the name and incorrect address are main factors which account for 86% in total unverified numbers of patients.

KEY WORDShospitals; pulmonary tuberculosis; prevention and control

综合医院是发现肺结核患者的主战场[1]。因此，综合医院及时报告和转诊肺结核疑/确诊患者到专业结防机构进行及时治疗，阻断结核菌的传播环节，对提高肺结核患者的发现率有着重要的作用和意义。其中肺结核患者追踪到位率是提高患者发现率的重要手段之一，也是卫生部要求的结核病防治工作“五率”中的组成部分。但是，在综合医院传染病网络报告肺结核疑/确诊患者实际工作中，由于诸多因素影响，对辖区内各社区卫生服务中心开展肺结核患者追踪到位带来不少困难。……