| Purpose To provide some guidance for the prevention and treatment of tuberculosis through understand the current situation of tuberculosis incidence,treatment and prognosis in Dingxi from 2005 to 2016,and analyze the causes of disease and the factors that influence the outcome of treatment;To provide a powerful basis for the control and prevention of TB through the analysis of the treatment outcome of tuberculosis patients in Dingxi during the 2010 to 2015;To provide the evidence for the clinical treatment of drug-resistant tuberculosis by observe the clinical characteristics of patients with drug-resistant pulmonary tuberculosis.Method1.Tuberculosis patients selected as the research object that in TB management information system of registration of Dingxi city from 2005 to 2016.To all patients treated according to the "guidelines for the implementation of China tuberculosis control program(2008)" and demands of the world health organization(WHO)standards set by the treatment,and then use modern tuberculosis control strategy(DOTS)to manage the patient,in the end,all information of patients were into the tuberculosis management information system.The population geographical and social information of the city of Dingxi were come from the "Dingxi Municipal Bureau of Statistics Yearbook".The epidemic data of tuberculosis from tuberculosis information management system.Adopt the method of description epidemiology study,input data using Excel2016,data statistics and analysis with composition ratio.A self-designedquestionnaire was used to investigate the behavioral characteristics,demographic and sociological characteristics of TB patients.2.Choose the cases of tuberculosis patients information which registed in TB management information system in Dingxi city from 2010 to 2015.The routine surveillance month,quarter,annual reports and documents that used for prevention and treatment from TB management information system.The population of the city of Dingxi were from the "Dingxi Municipal Bureau of Statistics Yearbook".Excel2016 was used for data entry,and the prognosis of TB treatment was analyzed by descriptive analysis.The hospitalization outcomes were analyzed according to different characteristics of the patients.3.100 cases of pulmonary tuberculosis in our hospital(February 2010-2016February)were treated as the research object.Divided into youth group(less than 39 years old),middle-aged group(40-59 years old)and the elderly group(over 60 years)according to different age.61 cases in young group,27 cases in middle age group and 12 cases in old group.All patients with drug-resistant pulmonary tuberculosis X-ray examination results were observed.Compare various age groups in patients with acquired drug resistance and primary drug resistance.At the same time,sputum bacterium negative conversation and the adverse reactions after treatment were observed during February,may,June and August.Result1.22471 patients with pulmonary tuberculosis were registered in Dingxi city during 2005-2016,with the general registration rate of 63.82/10 million,and showed a declining trend year by year.Reports about the number of pulmonary tuberculosis is more in Longxi,followed by Lintao,Tongwei,Anding District,Minxian,Weiyuan,Zhang county.The incidence of male than female,15-74 years old for peaks,accounted for 92.65%.Number is much higher than cities and towns,rural patientsfarmers accounted for 83.55%,followed by students,migrant workers,housework and unemployed people,workers,retirees and teachers etc.The management and cure rate of the new smear positive patients in Dingxi were 90%.The cure rate of retreatment smear positive patients was lower than that of the new smear positive patients,and the cure rate of the new smear positive patients was lower than that of the smear negative patients.2.The population of the city have risen from 2010 to 2011,and continue to decline since 2011.Rate of new smear-positive pulmonary tuberculosis patients found that has been in more than 70.00%,and the number of new smear positive pulmonary tuberculosis patients decreased from 2010 to 2015 in Dingxi city,decreased by6.24%.A total of 10953 patients with active tuberculosis in Dingxi city in 2010-2015,among which 7527 were smear-positive pulmonary tuberculosis patients,patients with active pulmonary tuberculosis registration rate from 2011 to 2015,decreased by18.49/10 million.Patients with active pulmonary tuberculosis and smear positive pulmonary tuberculosis in male patients were more than female.The increase of active tuberculosis patients with smear-positive pulmonary tuberculosis patients is larger with increasing with age in Dingxi city.20 years old,is a small peak incidence of pulmonary tuberculosis,and at the age of 40-80 years old,is tuberculosis incidence of big peak,which is more obvious at the age of 50-70 years old,and tuberculosis incidence is between 14%-22%,of which female women are mainly concentrated in years old,male are mainly concentrated in 50-60 years old.The active TB patients in Dingxi are mainly farmers,students,unemployed,retired personnel,teachers,cadres and staff which farmers and students have been top,accounted for92.78%.1750 cases were treated with retreatment,the retreatment rate was 15.98%,and 1399 cases were registered with smear positive pulmonary tuberculosis,accounting for 18.59% of the number of smear positive TB patients.Medicalinstitutions reported 9902 cases of suspected TB patients,the overall rate is 95.36%,and the rate of referral and follow-up is increasing year by year.The cure rate of new smear positive is higher than that of retreatment Smear Positive,and the mortality rate of retreatment Smear Positive is higher than that of new smear positive,and the mortality rate of new smear positive is higher than that of initial smear.3.There are 34 cases of acquired drug resistance,66 cases of primary drug resistance in all patients;young group of primary resistance was significantly higher than that of the middle-aged group and the elderly group,the difference was statistically significant(P<0.05);the middle age group of primary drug resistance rate compared with the elderly group,there was no significant difference(P>0.05);youth group with obtained drug resistance rate compared with the middle-aged and elderly group there was no significant difference(P>0.05);middle aged group with obtained drug resistance rate compared with the elderly group,there was not statistically significant(P>0.05).After treatment,chest X-ray examination revealed 3cases of deterioration,with no change in 20 cases,and absorption in 75 cases,in which 2 of them were not evaluated because of the loss of joint.In treatment,10 cases with adverse reactions,and carries on the corresponding treatment,the symptoms were alleviated,and continue to cooperate to complete the treatment.Conclusion:(1)On the whole,prevention and treatment of tuberculosis(TB)in Dingxi city presents the good situation,but still not optimistic,do a good job in the passive found patients work,also need to take the initiative to find patients,establish comprehensive TB prevention and control of network,improve the DOTS strategy,carry out teaching education,etc.(2)In the past six years,some measures to be taken by Dingxi city,and improve the new smear-positive pulmonary tuberculosis case detection rate,cure rate,thecomplete efficacy rate of smear-negative patients and overall rate.However we need to improve the education and monitor for farmers and students of tuberculosis,and strengthen the discovery of people with tuberculosis over the age of 50.(3)The clinical treatment of drug resistant tuberculosis should pay attention to drug resistance of pulmonary tuberculosis patients in different ages.If patients with drug-resistant,often influence cure effect,it will also increase the incidence of adverse reactions.For this case,the clinical treatment of tuberculosis should strictly implement the relevant standards,in order to avoid drug-resistant with patients and appear drug-resistant strains. |
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