中国作者重要发表 - 对具备和不具备分散肺结核服务的中国广西地区肺结核病人求医途径的分析



对具备和不具备分散肺结核服务的中国广西地区肺结核病人求医途径的分析





Analysis of care-seeking pathways of tuberculosis patients in Guangxi, China, with and without decentralised tuberculosis services





Wei X.-L., Liang X.-Y., Walley J.D., Liu F.-Y., Dong B.-Q. 2009/5/29 18:39:31

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International Journal of Tuberculosis and Lung Disease, 2009, Volume 13, Issue 4




SETTING: Tuberculosis (TB) care has been decentralised to township hospitals in a rural, poor area of Guangxi, China, since 1 April 2005. Routine county-based TB care was provided in a comparable control area. OBJECTIVE: To compare patients' care-seeking behaviours between the intervention and control groups. METHODS: In February 2007, all 230 new pulmonary TB smear-positive patients registered in the intervention and control groups between 1 April 2005 and 31 July 2006 were approached; of these, 171 were surveyed using a structured questionnaire. Their patient records were reviewed to minimise recall bias. RESULTS: Patients in the intervention group spent less for treating TB symptoms prior to TB diagnosis compared with the control group (P < 0.01). Travel costs were lower in the intervention than control group, but the difference was not statistically significant (P > 0.05). Diagnostic delays for patients in the intervention and control groups were respectively 26 and 38 days (t = -0.835, P> 0.05). Logistic regression suggested that visiting county general hospitals tended to prolong patient diagnostic delay and cost more before TB diagnosis. CONCLUSION: Decentralising TB services to township hospitals brought TB care closer to rural patients, shortened TB patient care-seeking pathways and reduced costs before TB diagnosis. © 2009 The Union.



Correspondence Address: Wei, X.-L.1227 Xietu Road, Shanghai, 200032, China; email: xiaolin.wei@utoronto.ca



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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

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干咳、间歇性气促2个月——《西氏内科学》病例

摘自：《西氏内科学》，第23版

患者女性，21岁，因干咳、间歇性气促2个月到急诊科就诊。开始症状为上呼吸道感染引起的鼻塞、流涕和咳嗽。医生检查后开了抗生素。服药后鼻部症状缓解，但仍有轻微干咳和呼吸困难。其他症状包括疲劳和焦虑。否认发热、体重减轻、胸痛、端坐呼吸、气喘、鼻后滴漏、胃灼热以及神经系统症状。

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