【摘要】：目的分析哈爾濱市急性弛緩性麻痹(Acute Flaccid Paralysis,AFP)病例流行病學(xué)特征及《AFP信息監(jiān)測(cè)管理報(bào)告系統(tǒng)》運(yùn)轉(zhuǎn)情況,為維持無(wú)脊灰狀態(tài)、制定疾病控制策略提供科學(xué)依據(jù)。方法采用描述流行病學(xué)和分析流行病學(xué)相結(jié)合的方法對(duì)AFP病例進(jìn)行流行病學(xué)特征分析,對(duì)監(jiān)測(cè)指標(biāo)進(jìn)行系統(tǒng)評(píng)價(jià)。結(jié)果 2004-2015年哈爾濱共計(jì)報(bào)告AFP病例529例,平均報(bào)告發(fā)病率為4.96/10萬(wàn),24 h內(nèi)報(bào)告率89.19%,報(bào)告后48 h內(nèi)調(diào)查率98.93%,14 d內(nèi)雙份合格便采集率為92.08%,便標(biāo)本7 d內(nèi)送達(dá)率為98.13%,75 d內(nèi)隨訪及時(shí)率均為100%。每年3-6月,7-10月為發(fā)病高峰;各區(qū)、縣(市)AFP報(bào)告數(shù)差異有統(tǒng)計(jì)學(xué)意義(χ2=133.19,P0.001);農(nóng)村病例多于城市(χ2=84.16,P0.001);病例城鄉(xiāng)二元居住狀況有統(tǒng)計(jì)學(xué)差異(χ2=441.33,P0.001);麻痹后第一次到省市級(jí)醫(yī)院就診的患者占76.37%,其余以縣級(jí)及以下醫(yī)院為主;68.80%的病例臨床癥狀體征不明顯;病例經(jīng)治愈后恢復(fù)良好,只有7.94%的患者殘留麻痹。就診次數(shù)、就診醫(yī)院情況等流行病學(xué)特征以及腹瀉、頸項(xiàng)強(qiáng)直等臨床癥狀體征均有統(tǒng)計(jì)學(xué)差異(P0.001)。結(jié)論哈爾濱AFP監(jiān)測(cè)系統(tǒng)運(yùn)轉(zhuǎn)情況良好,工作質(zhì)量逐年提高�；鶎俞t(yī)院對(duì)于AFP診斷能力和首診報(bào)告率低,應(yīng)重點(diǎn)對(duì)其開(kāi)展AFP診療培訓(xùn)工作,強(qiáng)化基層醫(yī)院診斷能力,做到早發(fā)現(xiàn)早報(bào)告。
[Abstract]:Objective to analyze the epidemiological characteristics of acute flaccid paralysis (Acute Flaccid Paralysis,AFP) cases and the operation of AFP Information Monitoring and reporting system in Harbin, so as to provide scientific basis for maintaining poliomyelitis and formulating disease control strategies. Methods Epidemiological characteristics of AFP cases were analyzed by combining descriptive epidemiology with analytical epidemiology, and the monitoring indexes were systematically evaluated. Results A total of 529 cases of AFP were reported in Harbin from 2004 to 2015. The average reported incidence rate was 4.96 / 100 000. The reporting rate was 89.19 in 24 hours. The investigation rate within 48 hours was 98.93% and the rate of double eligible stool collection within 14 days was 92.08%. The delivery rate of fecal specimens within 7 days was 98.13 and the prompt rate of follow-up within 75 days was 100. The incidence peak was from March to June and July to October. There was significant difference in the number of AFP reports in different districts and counties (蠂 2 / 133.19 / P 0.001), and the number of cases in rural areas was more than that in cities (蠂 2 / 84.16 / P 0.001). There was statistical difference between urban and rural dual living conditions (蠂 2 / 441. 3 / 3 P 0.001), 76.37% of the patients were admitted to provincial and municipal hospitals for the first time after paralysis, and the rest were hospitals at or below the county level. 68.80% of the cases had no obvious clinical symptoms and signs, and only 7.94% had residual paralysis. There were significant differences in the frequency of visits, hospital conditions, diarrhea, neck rigidity and other clinical symptoms and signs (P0.001). Conclusion the AFP monitoring system in Harbin is running well and the working quality is improving year by year. The diagnosis ability and the first diagnosis report rate of AFP are low in the primary hospital. It is necessary to focus on the training of AFP diagnosis and treatment, strengthen the diagnosis ability of the primary hospital, and make early discovery and early report.
【作者單位】： 哈爾濱市阿城區(qū)人民醫(yī)院兒科;哈爾濱市疾病預(yù)防控制中心免疫規(guī)劃所;黑龍江省第二醫(yī)院急診科;黑龍江省疾病預(yù)防控制中心公共衛(wèi)生監(jiān)測(cè)所;哈爾濱醫(yī)科大學(xué)公共衛(wèi)生學(xué)院;
【基金】：黑龍江省博士后科研啟動(dòng)金(LBH-Q12036)
【分類號(hào)】：R512.4

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