2010－2019年浙江省嘉兴市学生肺结核患者发现延误及其影响因素分析

胡洁; 顾伟玲; 王远航; 陈中文; 杜哲群; 沈国初; 许荣全

doi:10.3784/jbjc.202008050272

2010－2019年浙江省嘉兴市学生肺结核患者发现延误及其影响因素分析

Influencing factors for delay of pulmonary tuberculosis case finding in students in Jiaxing, Zhejiang, 2010–2019

摘要

摘要:
目的分析2010—22019年浙江省嘉兴市学生肺结核患者发现延迟及其影响因素，为卫生决策提供数据支持。
方法以2010—20192019年嘉兴市报告登记职业为学生的各学龄阶段肺结核患者为研究对象，包括幼托阶段、小学阶段、初中阶段、高中阶段、大学阶段，分析学生肺结核患者发现延误情况，采用单因素χ²检验及多因素logistic回归分析延误影响因素。
结果嘉兴市嘉兴市共报告学生肺结核患者443例，其中男性占60.05%，大学阶段占34.09%，病原学检查结果阴性占55.40%。学生肺结核发现时间的中位数为16 d，发现延误患者占30.70%。因症就诊、转诊、病原学检查阳性、空洞、重症是发现延误的危险因素。
结论嘉兴市学生肺结核发现延迟率维持在较低水平，针对发现延误危险因素，提倡新生入学健康体检等主动发现的方式，通过系统化的措施，减少延误的发生，推进学校重大风险防范。

Abstract:
Objective To investigate the delay of pulmonary tuberculosis (TB) case finding in students in Jiaxing, Zhejiang province, and the influencing factors, and provide data support for health decision-making.
Methods The information of pulmonary TB cases in students in child care settings, primary schools, junior high schools, senior high schools and colleges were collected form National Tuberculosis Information System for statistical analysis. The risk factors for the pulmonary TB case finding delay were analyzed by χ² test and multivariate Logistic regression model.
Results A total of 443 pulmonary TB cases were reported in students. The cases in boys accounted for 60.05% and the cases in college students accounted for 34.09%. In the reported pulmonary TB cases, 55.40% had negative etiological test results. The median delay days of pulmonary TB case finding in students was 16 days and the proportion of the cases with delayed finding was 30.70%. The risk factors of diagnostic delay were medical care seeking due to illness, referral, cavity, being etiological positive and severe pulmonary TB.
Conclusion It is necessary to promote the active pulmonary TB case finding at school entrance and take systematic intervention measures to reduce pulmonary TB case finding delay in schools.

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