1749例肺结核患者治疗依从性特点及影响因素分析

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目的分析贵州省肺结核患者治疗依从性特点及相关影响因素,为下一步制定提高患者治疗依从性措施提供依据。方法随机抽取10个县2013年11月1日-2014年5月31日期间治疗的1749例肺结核患者,收集患者的基本信息和治疗2月末、5月末和6(8)月末复查、取药延迟情况进行统计分析。结果 1749例患者治疗2月末、5月末、6(8)月末中曾出现过至少1次不依从1001例,占57.2%(1001/1749),出现过2次不依从300例,占17.2%(300/1749),出现过3次不依从89例,占5.1%(89/1749)。1001例不依从患者中,延迟2~9 d的占一半左右。经单因素统计分析,涂阳和涂阴患者、初治和复治患者总体依从情况差异有统计学意义,P<0.05。经多因素Logistic回归分析,患者诊断结果、初复治情况同时为患者治疗总体依从性的影响因素,P<0.05。涂阳患者总体依从性较涂阴患者好,初治患者总体依从性较复治患者好。结论贵州省肺结核患者治疗依从性特点为出现不依从比例大,延时时间主要集中在2~9 d,疗程结束时出现不依从比例高,诊断结果和初复治情况是患者依从性的影响因素。 Objective To analyze the characteristics of treatment compliance of pulmonary tuberculosis patients in Guizhou Province and the related influencing factors so as to provide the basis for further measures to improve the treatment compliance of patients. Methods A total of 1749 patients with tuberculosis who were treated in 10 counties from November 1, 2013 to May 31, 2014 were enrolled in this study. Basic information and treatment of patients were collected. The patients were reviewed at the end of February, the end of May and the end of 6 (8) Statistical analysis of the situation. Results There were at least 1 out of 1001 cases (57.2% (1001/1749), 2 out of 300 cases (17.2%) occurred in 1749 patients at the end of February, the end of May and the end of 6 (8) 300/1749), there were 3 cases of non-compliance 89 cases, accounting for 5.1% (89/1749). 1001 cases of non-compliance patients, delayed 2 ~ 9 d accounted for about half. The single factor statistical analysis, smear positive and smear negative patients, initial treatment and retreatment patients overall compliance were statistically significant, P <0.05. After multivariate logistic regression analysis, the results of diagnosis and initial treatment were the influencing factors for the overall compliance of patients, P <0.05. The overall compliance of smear-positive patients was better than that of smear-negative patients. The overall compliance of patients with newly diagnosed patients was better than that of patients with relapsed patients. Conclusion The treatment compliance characteristics of patients with pulmonary tuberculosis in Guizhou Province are that there is a large proportion of non-compliance, the delay time mainly concentrates in 2 ~ 9 days, and the non-compliance rate is high at the end of treatment, and the diagnosis and initial re-treatment are the influencing factors of patient compliance .
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