本文選題：傷寒副傷寒 + 診斷準(zhǔn)確性��； 參考：《現(xiàn)代預(yù)防醫(yī)學(xué)》2017年17期

【摘要】：目的了解云南省重點地區(qū)傷寒、副傷寒病例診斷的準(zhǔn)確性及符合率,為判明當(dāng)?shù)匾咔槭欠裾嬲甙l(fā)提供理論依據(jù)。方法依照國家診斷標(biāo)準(zhǔn)對重點地區(qū)2013-2015年報告的傷寒、副傷寒病例開展回顧性調(diào)查。分析比較不同病種、不同地區(qū)和不同級別醫(yī)療機(jī)構(gòu)診斷符合率及不符合情況。結(jié)果 460例調(diào)查病例中,傷寒病例占62.8%,副傷寒病例占37.2%。有135例病例完全符合診斷,總診斷符合率為29.35%,其中副傷寒診斷符合率高于傷寒(X~2=86.18,P0.001);不同地區(qū)和不同級別醫(yī)療機(jī)構(gòu)診斷符合率均存在差異(X~231.48,P0.001),地區(qū)以紅河州最高(62.22%),醫(yī)病機(jī)構(gòu)以州市級最高(45.52%)。有325例(70.65%)診斷不規(guī)范,其中169例(52%)應(yīng)排除診斷,156例(48%)應(yīng)訂正為傷寒、傷寒其它診斷類型。不符合診斷類型主要是傷寒和副傷寒確診病例。結(jié)論云南省傷寒、副傷寒病例診斷準(zhǔn)確性低,報告疫情數(shù)據(jù)不真實。按國家標(biāo)準(zhǔn)診斷、報告病例和重點開展病原菌分離、培養(yǎng)方法,有助于提高病例診斷的準(zhǔn)確性及符合率。
[Abstract]:Objective to understand the accuracy and coincidence rate of diagnosis of typhoid fever and paratyphoid fever in key areas of Yunnan Province, and to provide theoretical basis for determining whether the local epidemic situation is really high. Methods according to the national diagnostic criteria, the cases of typhoid and paratyphoid in key areas from 2013 to 2015 were investigated retrospectively. The diagnostic coincidence rate and nonconformities of different diseases, different regions and different levels of medical institutions were analyzed and compared. Results among 460 cases investigated, 62.8 cases were typhoid and 37.2% paratyphoid. 135 cases were in full conformity with the diagnosis. The diagnostic coincidence rate of paratyphoid fever was higher than that of Typhoid fever X2X (86.18U) P0.001N, and the diagnostic coincidence rate of X231.48U P0.001 was different in different regions and different grades of medical institutions. The highest rate of diagnosis in Honghe Prefecture was 62.22%, and the highest in medical institutions was 45.52%. Other diagnostic types of typhoid fever and typhoid fever should be revised. The main types of nonconforming diagnosis were confirmed cases of typhoid and paratyphoid fever. Conclusion the diagnostic accuracy of typhoid fever and paratyphoid fever in Yunnan Province is low, and the reported data are not true. It is helpful to improve the accuracy and coincidence rate of diagnosis according to the national standard, to report the cases and to carry out the isolation and cultivation of pathogenic bacteria.
【作者單位】： 云南省疾病預(yù)防控制中心;昆明市西山區(qū)疾病預(yù)防控制中心;
【分類號】：R181.3;R516.3

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