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目的分析柳州市新型结核病防治“三位一体”模式相较于旧模式取得的防治效果,为该方法的推广运用提供科学依据。方法采用描述流行病学方法,分析比较2009—2011年(旧模式)与2012—2014年(“三位一体”新模式)柳州市结核病防治的诊疗能力、人才配置以及患者发病情况、转诊率、转诊到位率、系统管理率、追踪率、追踪到位率、2个月末查痰率、涂阳患者治愈率、密切接触者筛查率、涂阴患者完成疗程率等指标。结果与旧模式相比,“三位一体”新模式期间,总肺结核发病率、涂阳肺结核发病率明显下降(χ~2=6.35,276.53,均P<0.05);系统管理率、转诊率均有所提升且呈逐年上升趋势(χ~2=23.213,625.83,χ~2_(趋势性)=8.28,11.78,均P<0.05);追踪到位率、密切接触者筛查率均有所提升,差异有统计学意义(χ~2=23.03和17.47,均P<0.05)。结论 “三位一体”结核病防治模式有效提升了柳州市结核病防治水平,具备可行性及可推广性。
Objective To analyze the prevention and cure effect of the new model of tuberculosis prevention and cure in Liuzhou City compared with the old model and provide a scientific basis for the promotion and application of this method. Methods The descriptive epidemiological method was used to analyze and compare the diagnosis and treatment ability, the allocation of talents and the incidence of tuberculosis in Liuzhou City between 2009-2011 (old model) and 2012-2014 ( “Trinity ” new model). The referral rate , Referral rate, system management rate, follow-up rate, follow-up rate, sputum rate at the end of 2 months, cure rate of smear-positive patients, screening rate of close contacts, smear-negative patients to complete the treatment rate and other indicators. Results Compared with the old model, the overall incidence of tuberculosis and the incidence of smear-positive pulmonary tuberculosis significantly decreased (χ ~ 2 = 6.35, 276.53, all P <0.05) during the new mode of “trinity” (Χ ~ 2 = 23.213, 625.83, χ ~ 2_ (trend) = 8.28, 11.78, all P <0.05). The follow-up rate and the rate of close contact screening were all improved , The difference was statistically significant (χ ~ 2 = 23.03 and 17.47, both P <0.05). Conclusion “Trinity ” mode of tuberculosis prevention and treatment effectively raised the level of prevention and treatment of tuberculosis in Liuzhou City, with feasibility and feasibility.