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目的了解肺结核患者发现延迟的影响因素,为制定结核病防治的有效措施提供科学依据。方法从结核病信息管理系统导出重庆市40个区县2008～2009年涂阳肺结核患者的个案资料,分析就诊延迟、发现延迟与相关因素之间的关系。结果在30845名涂阳肺结核患者中,就诊延迟时间中位数为38.0d,其中超过2周23895人(占77.47%);发现延迟时间中位数为46.0d,其中超过4周21930人(占71.10%)。涂阳病人的发现延迟与职业、年龄显著相关。相较于其他职业,农民发现延迟时间更可能大于4周,OR=1.474(P﹤0.05);相较于年龄小于65岁的患者,年龄大于65岁的患者发现延迟时间更可能大于4周,OR=1.234(P﹤0.05)。结论重庆市涂阳肺结核病人的就诊延误、发现延误情况较严重,特别是农村老年结核患者尤其严重。
Objective To understand the influencing factors of delayed detection in patients with pulmonary tuberculosis and provide a scientific basis for effective measures to prevent and control tuberculosis. Methods The case information of smear-positive pulmonary tuberculosis patients in 40 districts and counties in Chongqing from 2008 to 2009 was derived from the TB information management system. The relationship between the delay and the related factors was analyzed. Results The median delay time was 38.0 days among the 30,890 sputum smear positive pulmonary tuberculosis patients, including 23,895 patients (77.47%) over 2 weeks. The median delay time was 46.0 days, of which 21,930 were patients over 4 weeks 71.10%). The finding of smear-positive patients was significantly related to occupation and age. Compared with other occupations, farmers found that the delay time was more likely to be greater than 4 weeks, OR = 1.474 (P <0.05); patients older than 65 years were found to be more likely to be delayed for more than 4 weeks compared to patients younger than 65 years, OR = 1.234 (P <0.05). Conclusion The treatment of smear-positive pulmonary tuberculosis patients in Chongqing was delayed, and the delay was found to be more serious, especially in rural elderly patients with tuberculosis.