摘要
目的骨关节结核起病隐匿,易被误诊,患者不能坚持长疗程的抗结核治疗。摸索及总结出行之有效的模式对骨关节结核发现、规范化治疗显得尤为重要,从而提高其治愈率,降低致残率,恢复劳动力。方法与综合医院之间进行有效的沟通,并达成合作共识。在综合医院及其下属门诊、药店发放骨关节结核转介卡,如所有出现关节红肿、疼痛、流脓或畸形等骨关节病变情况的患者,立即在其所属区域医院或转送到我站进行结核方面的检查或筛查,一旦确诊,由我站进行规范化治疗。而我站的结核病患者中若有合并骨关节结核可疑症状者,同样开具转介卡到综合医院进行外科方面的处理,处理完毕后,及时再转我站继续进行抗结核治疗。这种医防包围式的治疗服务模式我们称之为医防合作模式。我站从2009年开始推行此模式进行骨关节结核患者的管理,现将2006～2008年在我站治疗的骨关节结核患者病例数设为对照组,将2009～2011年在我站治疗的骨关节结核患者病例数设为观察组。对疗程结束后的转归情况进行评价。结果对照组早期发现并确诊28例,早期发现率48.3%;治愈26例,治愈率44.8%;畸形15例,畸形率25.9%;致残11例,致残率19%;失败6例,失败率10.3%。观察组:早期发现并确诊63例,早期确诊率84%;治愈55例,治愈率73.3%;畸形12例,畸形率16%;致残5例,致残率6.7%;失败3例,失败率4%。结论在骨关节结核的治疗管理模式上,实施医防合作的模式能达到早期发现、早期治疗、提高治愈率、降低致畸残率、提高社会劳动能力的重要意义。
Objective Hidden onset of the bone and joint tuberculosis, easy to misdiagnosed, patients can＇ t insist on long course of anti - tb treatment are the problems we must face to. So it is particularly important to grope and summed up the effective mode of bone and joint tuberculosis detection and standardize the treatment in order to improve the cure rate and reduce disability rate, elevate recovery of labour. Methods To communicate effectively with general hospital and reach a consensus on cooperation. In general hospital and its affiliated clinics, pharmacies issue joint tuberculosis referral CARDS to relevant patients. During discover any joints with redness, pain, or abnormality of bone joint disease in the patients, immediately carry out tuberculosis check or screening in the region hospital or refered to our station for checking. Once confirmed the patient will be given standardized treatment by our station. When the patient in our station reveal TB joint suspicious symptomes, we will give referral CARDS to him for general hospital surgical treatment. After processed, in a timely manner we will continue anti - tb treatment. This treatment and prevention surreound type service pattern we call medical cooperation pattern. Since 2009 our station implement this pattern for TB bone and joint patients management. Now all cases of bone and joint TB from 2006 to 2008 were selected as control group, and those patients from 2009 to 2011 were selected as observation group, evaluate the outcomes of the two groups after completion of treating course. Results In control group 28 cases early detected and diagnosed, early detection rate is 48.3% ; Cure of 26 cases, the cure rate was 44.8% ; 15 cases were deformed, deformity rate is 25.9% ; 11 cases of disaability, the disability rate was 19% ; 6 cases of failure, failure rate 10o 3%, In observation group： Early detection and diagnosis of 63 cases, early diagnosis rate is 84% ; cured 55 ca- ses, cure rate 73.3% ; deformity 12 cases, deformity rate 16% ; 5 cases of disability, the disability rate was 6.7% ; 3 cases failure, failure rate 4%. Conclusion On bone and joint tuberculosis treatment management mode, implementation of medical cooperation mode can achieve early discovery, early treatment, improve the cure rate, reduce deformity and disability, with the significance of improving the ability of social labor.
出处
《现代医院》
2013年第9期154-156,共3页
Modern Hospitals
关键词
骨关节结核
医防合作
早期发现率
治愈率
Bone and joint tuberculosis, Medical cooperation, Early detection rate, The cure rate
