摘要
目的 分析我国2019年年龄≥65岁肺结核患者随访检查依从性,为进一步规范患者治疗管理提供依据.方法 通过"中国疾病预防控制信息系统"子系统"结核病管理信息系统"收集2019年全国登记治疗的年龄≥65岁且利福平敏感的初治肺结核患者的病案信息,对患者的基本特征,治疗第2、5、6个月末随访检查完成率以及随访检查依从率进行描述性分析,采用二元多因素Logistic回归分析患者随访检查不依从的影响因素.结果 2019年我国老年利福平敏感初治肺结核患者治疗第2、5、6个月随访检查的完成率分别为95.5％、89.9％、86.0％,总体呈下降趋势(x2趋势=-2.287,P=0.022).患者随访检查的依从率为87.4％(48 834/55 888).多因素logistic回归分析显示,女性、≥80岁、家务工作者、离退人员、其他职业、东部地区和西部地区、流动人口、有合并症、诊疗单位为综合医院、专科医院的患者随访检查不依从的风险较高,诊疗单位为社区卫生服务中心的患者随访检查不依从的风险较低.结论 2019年我国老年利福平敏感初治肺结核患者的随访检查工作成效显著,但仍需加强东、西部地区以及流动人口、专科医院诊疗患者管理和关怀工作,进一步规范治疗随访以提高患者的治愈率.
Abstract
Objective To analyze the follow-up examinations compliance of elderly(aged≥65)pulmonary tuberculosis(PTB)patients in China in 2019,and provide evidence for further standardization of treatment management.Methods The medical records of new,rifampicin-sensitive and elderly PTB patients who were registered for treatment in 2019 were extracted from the Tuberculosis Information System(TBIMS),a subsystem of the Chinese Disease Control and Prevention Information System.Descriptive analysis was conducted on the basic characteristics of patients,the rates of completion of the follow-up examinations at the end of the 2nd,5th,and 6th months of treatment,as well as the rate of adherence to follow-up examinations.Binary logistic regression model was used to analyze the factors affecting the patients'non-adherence to follow-up examinations.Results In 2019,the completion rates of follow-up examinations of the 2nd,5th,and 6th months of treatment in new,rifampicin-sensitive and elderly PTB patients in China were 95.5％,89.9％and 86.0％,respectively,with an overall decreasing trend(x2rend=-2.287,P=0.022).The compliance rate of follow-up examinations was 87.4％(48 834/55 888).Logistic regression analysis showed that female,≥80 years old,domestic workers,retirees,other occupations,eastern and western regions,migrant populations,patients with comorbidities,diagnosed and treated in general hospitals or specialized hospitals had a higher risk of non-compliance with follow-up examinations,while patients who diagnosed and treated in community health centers had a lower risk of noncompliance during follow-up examinations.Conclusions The follow-up examinations of elderly rifampicin-sensitive new PTB patients in China were effective in 2019,but there is still a need to strengthen the management and care of eastern and western areas as well as migrant populations and patients in specialized hospitals,and further standardize treatment follow-up to improve the cure rate of patients.
基金项目
结核病预防控制项目(2024)(2428)
国家科技重大专项(十三五)(2017ZX10201302)
国家科技期刊平台
NSTL
万方数据