【摘要】 目的:探索麻风低流行区开展麻风防治工作的模式。方法:选择麻风低流行县进行5年试点,结合试点实际情况和参照WHO1986年倡导的麻风防治一体化策略定义,在使用定性研究论证该策略可行性的基础上,运用行政干预等手段,建立县、乡、村医疗机构以及麻风防治业务机构组成的麻风防治综合性网络。结果:确立了"以当地政府为主导,依靠行政和经济干预等手段,以麻风防治业务机构为制定计划、核实诊断、培训、督导、评估等为业务指导管理中心,依靠县、乡、村综合性医疗机构为服务实体开展麻风病监测、病人管理、社会宣传、就近医疗救助和康复服务"的麻风低流行地区的防治模式。该模式使得各级政府更加了解和重视麻风防治工作;普遍提高医务人员和群众的麻风防治知识水平和参与意识;增强综合性医疗机构病人发现与管理以及麻风康复工作的能力;绝大多数麻风残疾者能获得就近康复服务。结论:该模式是可行的,并可实现低流行状态下麻风防治工作的可持续发展。县是实施这一模式的最小平台单位,政府支持是该模式运行的根本保证。更多还原

【Abstract】 Objectives To explore the leprosy prevention and treatment model in leprosy low-epidemic areas.Methods We chose leprosy low-epidemic counties and conducted pilot for five years.We combined actual situation with leprosy prevention and treatment integration strategy recommend by WHO in 1986.On the basis of the feasibility of this strategy proved with qualitative method,by use of administrative interventions,the leprosy prevention and treatment comprehensive network that is consist of county,township,village and leprosy special prevention and treatment institutes.Results The leprosy prevention and treatment comprehensive model is established,which is local government-oriented;relies on administrative and economic intervention measures;regards leprosy special prevention and treatment institute as business guiding and management center that is responsible for plan formulation,checking out and diagnosis,training,supervision and appraisal;relies on county,township and village medical institutes as service subject to carry out leprosy monitoring,disease management,social propaganda,medical assistance and rehabilitative service.This model makes governments at different levels learn more about and pay attention to leprosy prevention and treatment;makes health workers’ and residents’ leprosy prevention and treatment knowledge improve and consciousness of participation increase;strengthens the general medical institutes’ abilities of finding out patients,patients management and rehabilitation work;the most of disabled persons for leprosy could get rehabilitative service nearby.Conclusions This model is feasible and realizes the sustainable development of leprosy prevention and treatment work under the condition of low-epidemic stage.County is the smallest platform unit to implement this model.The government support is the fundamental guarantee for the operation of this model.更多还原