【摘要】 目的研究传染性肺结核病人诊断延迟有关影响因素,为提高涂阳病人发现率,控制结核病传播提供依据。方法设计肺结核流行病学个案调查表,选择5个县的结核病防治专科门诊,对门诊就诊的涂阳肺结核病人进行个案调查,并进行流行病学统计分析。结果148例涂阳病人,就诊延迟117例,就诊延迟率79.1%;确诊延迟84例,确诊延迟率56.8%;发现延迟101例,发现延迟率68.2%。年龄因素中,>60岁年龄组病人,诊断延迟率高于其他年龄组病人。性别因素中,女性高于男性;文化程度因素中,文盲高于其他学历。病人自己不在乎是未就诊的主要原因,乡镇卫生院结核病诊治水平是确诊延迟的重要原因。结论加强政府承诺,改善医疗卫生服务,加大结核病防治宣传力度,增强群体自我保健意识,是降低就诊延迟率的关键。规范和提高结核病诊治能力,落实结核病归口管理,是降低确诊延迟率和发现延迟率的关键。更多还原

【Abstract】 Objective To understand correlative influential factors leading to delayed diagnosis of infective pulmonary TB cases so as to provide basis for increasing discovery rate of smear-positive cases,reducing the transmission of TB.Methods A questionnaire was worked out for the TB cases investigation.Five TB prevention and control subject clinics at county level were selected for individual investigation of the smear-positive TB cases.The data were analyzed with statistical method.Results 148 smear-positive TB cases were included in this investigation.Of them,117cases were consultation delay with the rate 79.1%,84 cases were confirmed diagnosis delay with the rate 56.8% and 101 cases were discovery delay with the rate 68.2%.The rate of diagnosis delay in the group of >60 years old cases was higher than that of other age groups.The rate of female cases was higher than that of male cases.The rate of illiteracy was higher than that of people with higher education background.The main reason of consultation delay was neglect of the patients.The major reason of conformed diagnosis delay could be ascribed to poor diagnostic level at the small town s ’public health clinics.Conclusion Strengthening the government commitment,improving the service of the medical health,enlarging the disseminative degree of the TB prevention and control and enhancing the community’s self-health mentality are the keys to reduce the rate of consultation delay.Standardize and enhance the diagnostic ability of TB and ascertain TB Convergence Case-management are the keys to reduce the rates of confirmed diagnosis delay and discovery delay.更多还原