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陈松华, 王晓萌, 钟节鸣, 陈彬, 黄玉. 肺结核病新患者发现延误及影响因素分析[J]. 中国公共卫生, 2013, 29(4): 481-484. DOI: 10.11847/zgggws2013-29-04-05
引用本文: 陈松华, 王晓萌, 钟节鸣, 陈彬, 黄玉. 肺结核病新患者发现延误及影响因素分析[J]. 中国公共卫生, 2013, 29(4): 481-484. DOI: 10.11847/zgggws2013-29-04-05
CHEN Song-hua, WANG Xiao-meng, ZHONG Jie-ming.et al, . Factors associated with diagnostic delay for primary pulmonary tuberculosis patients in Zhejiang province[J]. Chinese Journal of Public Health, 2013, 29(4): 481-484. DOI: 10.11847/zgggws2013-29-04-05
Citation: CHEN Song-hua, WANG Xiao-meng, ZHONG Jie-ming.et al, . Factors associated with diagnostic delay for primary pulmonary tuberculosis patients in Zhejiang province[J]. Chinese Journal of Public Health, 2013, 29(4): 481-484. DOI: 10.11847/zgggws2013-29-04-05

肺结核病新患者发现延误及影响因素分析

Factors associated with diagnostic delay for primary pulmonary tuberculosis patients in Zhejiang province

  • 摘要: 目的 了解浙江省新发肺结核患者发现延误的影响因素,为肺结核的早期控制提供科学依据。方法 采用回顾性研究方法收集浙江省2009年1月1日—12月31日确诊登记的31 287例新发肺结核患者病案资料,分析患者发现延误的影响因素。结果 浙江省新发肺结核患者就诊延误、诊断延误和发现延误时间中位数分别为17、1和21 d,就诊延误、诊断延误和发现延误率分别为55.66%、7.06%和62.91%;多因素logistic回归分析结果表明,羁押人群、发现地区地形为山地/岛屿、涂阳和重症患者是浙江省新发肺结核患者发现延误的危险因素;男性、15~59岁、学生/儿童、教师/医务人员/职员、服务行业人员、其他职业人员、省外流动户籍、患者来源为健康检查/转诊/追踪、发现地区地形为盆地/丘陵、诊治单位为定点医院是浙江省新发肺结核患者发现延误的保护因素。结论 新发肺结核患者就诊延误时间明显较诊断延误长;性别、年龄、职业、户籍、是否羁押人群、患者来源、发现地区地形、诊治单位类型、诊断结果、是否重症是浙江省新发肺结核患者发现延误的影响因素。

     

    Abstract: Objective To explore the impact factors of diagnostic delay for primary pulmonary tuberculosis(TB) patients,and to provide basis for early control of tuberculosis.Methods With retrospective design,the information for 31 287 primary(TB) cases were collected from medical records from January 1 to December 31,2009 to analyze the impact factors of diagnostic delay.Results The median of patient delay,doctor diagnostic delay,total patient delay time was 17 days,1 day,and 21 days and the rate of patient delay,doctor diagnostic delay,total patient delay was 55.7%,7.1%,and 62.9%,respectively.Logistic regression analyses showed that risk factors for diagnostic delay included female,children and elderly,with low-income occupation,having treatment of other diseases,living in island or mountainous area,being diagnosis and treatment in public heath institution,smear-positive cases,severe cases,and detention individuals.The protective factors for diagnostic delay included male,young and adults,with high-income occupation,floating population,taking physical examination and referral track in plain or basin areas,having diagnosis and treatment in the fixed hospital,smear-negative cases,and minor cases.Conclusion The patient delay time is significantly longer than doctor diagnostic delay time.The impact factors of diagnostic delay for primary pulmonary tuberculosis patients included gender,age,occupation,household,being detention individual,patient source,living area,type of treatment and diagnosis institution and the state of TB.

     

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