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目的评价两种日常推荐发现病人的方式在结核病控制工作中的可行性和作用。方法乡村医生发现的肺结核病可疑症状采取直接转诊到县疾病预防控制中心(日常推荐方法1)或“乡村医生日常推荐肺结核病人可疑症状、乡镇卫生院放射科诊断疑似肺结核病人、县疾病预防控制中心定诊肺结核病人”的方法(日常推荐方法2)发现肺结核病人。结果①日常推荐方法2的肺结核病检出率明显高于日常推荐方法1;②日常推荐方法2的病人支出成本低于日常推荐方法1;③咳血或痰中带血肺结核检出率75.4%,咳嗽、咳痰大于3周肺结核病检出率8.5%。结论乡村医生发现咳血或痰中带血病人时直接转诊到县疾病预防控制中心,咳嗽、咳痰大于3周可先转诊到乡镇卫生院放射科,若初步诊断为疑似肺结核病再进行转诊,咳嗽、咳痰大于3周同时伴有不明原因长期低热、乏力、盗汗、胸痛、消瘦的病人可根据交通条件和转诊医生对该病人的认识程度再决定转诊到当地卫生院或县疾病预防控制中心。
Objective To evaluate the feasibility and role of two daily recommended patient discoveries in tuberculosis control. Methods Rural doctors found suspicious symptoms of tuberculosis to refer directly to the county CDC (routine recommended method 1) or “Rural doctors routinely recommend suspicious symptoms of tuberculosis, the township hospitals radiology diagnosis of suspected tuberculosis patients, county disease prevention Control center clinically diagnosed tuberculosis patients ”(daily recommended method 2) to find tuberculosis patients. Results (1) The detection rate of tuberculosis in routinely recommended method 2 was significantly higher than that of daily recommended method 1; (2) the daily cost of patient recommended method 2 was lower than that of daily recommended method; (3) the detection rate of hemocontrast tuberculosis in hemoptysis or sputum was 75.4% , Cough, sputum more than 3 weeks detection rate of tuberculosis 8.5%. CONCLUSIONS: Rural doctors directly refer to the county CDC when they found blood in patients with hemoptysis or sputum. Patients with cough and phlegm more than 3 weeks may be referred to the radiology department of township hospitals. If the initial diagnosis is suspected pulmonary tuberculosis, referral is made , Cough, sputum more than 3 weeks accompanied by unexplained long-term low fever, fatigue, night sweats, chest pain, weight loss of patients according to traffic conditions and referral doctor’s understanding of the patient before deciding to refer to the local hospital or county disease Prevention and Control Center.