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目的了解温岭市某职业高中学生肺结核发病情况,为预防结核病在学生群体中的传播蔓延提供参考依据。方法通过对发病学生的流行病学调查,接触者进行PPD试验、胸部X线检查及跟踪随访。结果疫情班级活动性肺结核13例,罹患率为28.89%(13/45);PPD试验,疫情班级强阳性12例,阳性16例,阳性、强阳性率为65.12%(28/43),对照班级阳性2例,无强阳性,阳性、强阳性率为7.14%(2/28),疫情班级高于对照班级,差异有统计学意义(χ2=24.11,P<0.01);疫情班级PPD试验结果,11例活动性肺结核中阴性2例,PPD阴性率为18.18%(2/11),疫情班级PPD试验结果与活动性肺结核差异无统计学意义(χ2=3.38,P>0.05);首发病例为涂阴肺结核患者;首发病例隐瞒病情、中断治疗,导致疫情在聚集性场所扩散蔓延。结论早期及时发现病人、积极规范抗结核治疗是预防肺结核传播的关键;PPD试验作为活动性肺结核筛查存在局限性,需结合胸部X线检查。
Objective To understand the incidence of tuberculosis in a vocational high school student in Wenling and to provide a reference for preventing the spread of tuberculosis in the student population. Methods According to the epidemiological investigation of the affected students, PPD test, chest X-ray examination and follow-up were conducted. Results In the PPD test, 12 cases were positive and 16 cases were positive, with a strong positive rate of 65.12% (28/43) in control group (2/28). The grade of epidemic situation was higher than that of control class, the difference was statistically significant (χ2 = 24.11, P <0.01). The result of class PPD test of epidemic situation showed that the positive rate was 7.14% There were 2 negative cases in 11 cases of active pulmonary tuberculosis, the negative rate of PPD was 18.18% (2/11). There was no significant difference between active class and active tuberculosis in class epidemic PPD test (χ2 = 3.38, P> 0.05) Negative pulmonary tuberculosis patients; the first case hides the condition, interrupt treatment, resulting in spread of spread in the gathering place. Conclusions The early detection of patients in time and actively regulate the anti-TB treatment is the key to prevent the spread of pulmonary tuberculosis; PPD test as active pulmonary tuberculosis screening limitations, the need to combine chest X-ray examination.