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目的分析湘西自治州实施现代结核病控制策略15年效果。方法收集并分析1992-2006年结核病项目工作报表及相关资料。结果15年共发现并免费治管活动性肺结核病人29989例,其中初治涂阳病人14120例,复治涂阳病人4535例,新发涂阴病人11334例。初治涂阳病人平均治愈率为92.2%,复治涂阳病人平均治愈率为86.3%,新发涂阴病人治疗成功率为96.5%。共计投入资金1313.87万元,平均发现并免费治疗和管理一例病人投入438.12元,减少了14200人因结核病死亡,使350000～524000名健康人免遭结核病的感染,产生的直接效益为2800万元,节约家庭直接成本为4900万元,产生的家庭直接效益为1.3亿元。全州新涂阳病人登记率由1993年的18.8/10万上升至2005年的64/10万,且历年来均高于湖南省平均值。结论现代结核病控制策略的推行,极大地促进并规范了湘西州结核病防治工作的实施,真正实现了结核病人高发现率和高治愈率的目标,取得了十分显著的社会效益和经济效益。但湘西州结核病高感染率导致高发病率的状况在短期内难以得到根本改变,只有继续推行并完善现代结核病控制策略,才能有效地控制结核病疫情。
Objective To analyze the effect of 15 years of modern TB control strategy in Xiangxi Autonomous Prefecture. Methods Collecting and analyzing the work report of tuberculosis project from 1992 to 2006 and related materials. Results A total of 29,989 active pulmonary tuberculosis cases were found and administered for free for 15 years. Among them, 14,120 were smear-positive patients, 4,535 were smear-positive patients and 11,334 new smear-negative patients. The average cure rate of smear-positive patients was 92.2%, the average cure rate of smear-positive patients was 86.3%, and the success rate of new smear-negative patients was 96.5%. A total investment of 13,138,700 yuan, found and free treatment and management of an average patient invested 438.12 yuan a case, reducing 14,200 deaths due to tuberculosis, so that 350000 ~ 524000 healthy people from tuberculosis infection, the direct benefit of 28 million yuan, The direct cost saving for the family is 49 million yuan, resulting in a direct family benefit of 130 million yuan. The state registration rate of new smear-positive patients rose from 18.8 / 100,000 in 1993 to 64 / 100,000 in 2005, and it is higher than the average of Hunan Province over the years. Conclusion The implementation of modern TB control strategy has greatly promoted and standardized the implementation of tuberculosis prevention and control work in western Hunan, and has really achieved the goal of high detection rate and high cure rate of TB patients, and has achieved remarkable social and economic benefits. However, the high morbidity rate of TB caused by high TB prevalence in Hunan is unlikely to be fundamentally changed in the short term. Only by continuing to implement and perfecting modern TB control strategies can TB disease be effectively controlled.