论文部分内容阅读
目的掌握山西省克山病病区病情和防控措施落实现状,评价“十二五”期间(2011─2015年)克山病病区实现控制和消除目标的进展情况。方法 2013年12月─2015年3月,在山西省所有病区县分两批开展克山病病例搜索;然后每县抽取2个病区乡(镇),每乡(镇)抽取1个病区村为调查点,对调查点全部人口开展克山病重点调查;对照国家《克山病控制和消除评价内容及判定标准》评估各县“十二五”期间克山病病区的控制和消除状况。结果在山西省11个病区县,搜索县级医疗机构24个、病区乡卫生院17个、病区村卫生室55个,未发现新克山病病例;重点调查15个乡(镇),未发现急型、亚急型克山病病人;心电图描记8 827例,检出异常心电图555例(异常率6.29%),心电图异常改变681项次,以ST-T改变(占23.49%)和完全性右束支传导阻滞(占14.98%)为主;81例和44例疑似慢型克山病病人分别拍摄心脏正位片和心脏彩超检查,心脏增大者分别为38例(46.91%)和9例(20.45%);共诊断克山病116例,总检出率1.29%,其中潜在型克山病101例(1.12%),慢型克山病15例(0.17%);男女患病性别比为1∶0.93(60/56);45岁以上病例占病例总数的88.79%(103/116);广灵、大宁、永和、隰县、安泽、沁源县达到消除标准,蒲县、浮山、石楼、交口县达到控制标准,吉县未达到控制标准。结论依据国家《克山病控制和消除评价内容及判定标准》,2011─2015年山西省克山病病情已得到稳定控制,除吉县屯里乡外已全部达到消除或控制标准;鉴于潜在型克山病诊断极易与其他心率失常混淆,建议在判定病区的控制或消除中应主要根据慢型克山病患病率特别是自然慢型克山病患病率判定。
Objective To understand the status quo of the disease and prevention and control measures in Keshan disease ward of Shanxi Province and evaluate the progress of controlling and eliminating the target in Keshan disease ward during the “Twelfth Five-year Plan” (2011-2015). Methods From December 2013 to March 2015, Keshan disease cases were searched in two batches in all ward counties in Shanxi Province. Then, two ward townships (towns) were selected in each county, and one disease was collected in each township (town) District village as a survey point, the investigation of all population Keshan disease key survey; control country “Keshan disease control and elimination of evaluation content and criteria” to assess the county “Twelve-Five ” period Keshan disease Control and eliminate the situation. Results In 11 ward counties of Shanxi Province, 24 county-level medical institutions, 17 ward township hospitals and 55 ward village clinics were searched. No cases of Naksan disease were found. 15 townships (towns) There were 8 827 cases of electrocardiogram, 555 cases of abnormal electrocardiogram (abnormal rate 6.29%), 681 cases of electrocardiogram anomalous changes, and ST-T changes (23.49%) And complete right bundle branch block (accounting for 14.98%). 81 patients and 44 patients with suspected chronic Keshan disease were examined by echocardiography and echocardiography respectively. The patients with cardiac enlargement were 38 (46.91% ), And 9 cases (20.45%). A total of 116 cases of Keshan disease were diagnosed with the total detection rate of 1.29%, of which 101 cases (1.12%) were latent Keshan disease and 15 cases (0.17%) were chronic Keshan disease. Male and female prevalence of sex 1: 0.93 (60/56); 45 years of age or more cases accounted for 88.79% (103/116); Guangling, Daning, Yonghe, Shexian, Anze, Qinyuan County to eliminate Standard, Puxian, Fushan, stone floor, Jiaokou County reached the control standards, Ji County did not meet the control standards. Conclusions According to the national “Keshan Disease Control and Elimination Evaluation Content and Criteria”, Keshan disease in Shanxi Province has been steadily controlled from 2011 to 2015 except that all of the villages in Tunli, Jixian County have been eliminated or controlled. In view of the potential type Keshan disease diagnosis easily confused with other heart rate disorders, it is recommended in determining the ward control or elimination should be based mainly on the prevalence of chronic Keshan disease, especially the natural slow Keshan disease prevalence rate.