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潜伏性结核感染预防性治疗中的医学困境及解决策略

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潜伏性结核感染有发展为活动性结核病可能,长周期的预防性抗结核治疗存在诊疗方案不统一、医疗费用高、各种不同程度的药物不良反应等问题.以西安市某结核病专科医院2021-2023年潜伏性结核感染门诊患者为研究对象,分析讨论潜伏性结核感染在预防性治疗中面临的医学困境.针对目前潜伏性结核感染患者人次逐年成倍增加、患病人群年轻化、以女性为主、≥90%患者为自费支付这些现状,需制定潜伏性结核感染诊疗标准、减少不良反应发生;保证患者对长周期规范性治疗的充分知情;完善医保支付范畴,减少个人经济负担,尤其对育龄期妇女进行专项资助等,为潜伏性结核感染的临床诊疗和有效防控提供实践参考.
Medical Dilemmas and Solving Strategies in the Prophylactic Treatment of Latent Tuberculosis Infection
Latent tuberculosis infection(LTBI)carries the risk of progressing to active tuberculosis,and its long-term prophylactic treatment is fraught with challenges,such as inconsistent treatment protocols,high medical costs,and varying degrees of adverse drug reactions.This study focuses on the patients of a tuberculosis specialty hospital in Xi'an from 2021-2023,analyzing the medical dilemmas faced by LTBI in prophylactic treatment.The current situation is that the number of LTBI patients is increasing exponentially year by year,the younger demographic,predominance of female patients,and over 90% of the patients are self-paying.It is necessary to establish standardized diagnostic and treatment protocols for LTBI,minimize adverse reactions,ensure that patients are fully informed of the long-term standardized treatment,expand insurance coverage to reduce individual financial burdens,and provide special financial support for women of childbearing age.These strategies aim to provide practical references for clinical diagnosis and treatment,as well as for the effective prevention and control of LTBI.

latent tuberculosis infectionprophylactic treatmentmedical dilemma

王丽莎、李娜、闫晓婷、丁超、刘玉钢

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西安交通大学第一附属医院康复医学科 陕西西安 710061

西安交通大学第一附属医院医务科 陕西西安 710061

西安市胸科医院胸外科 陕西西安 710061

潜伏性结核感染 预防性治疗 医学困境

2023年陕西省一般项目社会发展领域基金项目2024年陕西省一般项目社会发展领域基金项目

2023-YBSF-3362024SF-YBXM-693

2024

医学与哲学
中国自然辩证法研究会

医学与哲学

CSTPCDCHSSCD北大核心
影响因子:1.314
ISSN:1002-0772
年,卷(期):2024.45(18)
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