【摘要】 目的分析深圳市梅毒报告病例诊断的准确性和规范治疗情况,为进一步改进梅毒监测和防治工作提供依据。方法从中国疾病预防控制信息系统中,导出2013年7月1日至2014年6月30日,深圳市各医疗机构网络报告的梅毒病例。采用抽样调查方式,由专业人员将之与医疗机构的门诊日志、实验室检测结果、药房处方等进行核对,按国家梅毒诊断标准和治疗指南,评估报告病例是否准确诊断和规范治疗。结果共调查梅毒报告病例1589例,分期正确率为95.53%(1518例)。其中一期梅毒正确率为83.59%(163/195),二期梅毒为96.60%(341/353),三期梅毒为97.73%(43/44),胎传梅毒为100.00%(19/19),隐性梅毒为97.34%(952/978)。规范治疗率为67.84%(1078/1589),其中青霉素药物治疗率为66.08%(1050/1589),替代药物治疗率为1.76%(28/1589)。结论深圳市梅毒诊断准确率较高,但规范治疗率低于国家要求,应进一步加强培训和督导,完善传染病报告卡梅毒诊疗信息的填写,提高梅毒诊断准确率和规范治疗率。更多还原

【Abstract】 Objective To investigate the accurate rate of diagnosis and the standardized rate of treatment among reported syphilis cases in Shenzhen and to provide evidence for further prevention strategies.Methods Data of syphilis cases reported from July 1,2013 to June 30,2014 were downloaded from the‘China Information System for Disease Control and Prevention’.Randomized sampling method was used to select cases from the download database.Medical staffs compared the information from the selected cases with doctors’ daily record,patients’ laboratory test results and pharmacy prescriptions from medical institutions.The accuracy of diagnosis and standardization of treatment were evaluated based on the Diagnostic Criteria and Management of Syphilis Guidelines(Ministry of Health,China,2007).Results This study totally selected 1589 syphilis cases for evaluation.The accurate rate of diagnosis was 95.53%for total,and the rates were 83.59%,96.60%,97.73%,100.00%and 97.37%respectively for primary,secondary,tertiary,congenital and latent syphilis.Nearly 66.08%cases were treated with penicillin therapy and 1.76% cases were treated with replacement therapy.The standardized rate of treatment was 67.84%.Conclusion The accurate rate of syphilis diagnosis is high in Shenzhen.However,the standardized rate of treatment is far from the goal set in the national syphilis control plan.It suggests that training and supervision should be enhanced and modification of communicable disease card(such as adding the diagnosis and treatment information of syphilis cases)should be considered to improve the rate of accurate diagnosis and standardized treatment of syphilis cases.更多还原