【摘要】 目的分析村医推荐疑似肺结核患者,对提高疑似肺结核患者就诊率和新涂阳肺结核患者发现率的效果。方法在30个县由经过培训的乡村医生对肺结核可疑症状者进行摸底,推荐到县结防机构或附近的乡镇、综合医院查痰点进行免费查痰,并给予每位确诊的活动性肺结核患者交通补助费8元,每确诊1例涂阳肺结核患者,奖励推荐村医24元。所有数据处理均采用SAS 8.1软件统计工作分析。结果一年项目期,疑似肺结核患者就诊率由1.4‰提高到1.8‰,村医推荐疑似肺结核患者就诊率由0.2‰提高到0.6‰,新涂阳登记率由项目实施前的36.2/10万,提高到49.9/10万,新涂阳患者发现率由64.6%提高到86.0%,推荐和自己就诊疑似患者中涂阳检出率分别为50.3%和45.6%,其中新涂阳患者占涂阳患者比例分别为86.3%和80.3%。结论采用村医推荐方法,能有效提高疑似肺结核患者就诊率和新涂阳患者的发现率。更多还原

【Abstract】 Objective To analyze the effect of increasing TB-suspect consulting rate and NSPTB(new smear positive pulmonary tuberculosis) notification rate through TB-suspect referral by village doctor for further diagnosis.Methods Village doctors were first trained to make preliminary diagnosis for the TB-suspects in 30 counties,the suspects were referred to the county TB dispensary or nearby microscopy center of the township/general hospital for confirmation.Every confirmed-NSPTB patient would have 8 Renminbi yuan as transportation subsidy,while every village doctor referring 1 NSPTB patient would have 24 Renminbi yuan as allowance.All the data were analyzed by SAS8.1.Results In the year of the project period the suspect-consulting rate increased from 1.4‰ to 1.8‰,and the suspect-consulting rate referred by village doctor increased from 0.2‰ to 0.6‰.The NSP registering rate increased from 36.2/105 to 49.9/105,and the notification rate increased from 64.6% to 86.0%,The smear positive detection rate of referral and self-consultation were 50.3% and 45.6% respectively.Among them,NSP was 86.3% and 80.3% respectively.Conclusions The implementation of the system of TB-suspect referral by village doctor,and the incentive given to village doctor could effectively increase the suspect-TB consulting rate and NSP notification rate.更多还原