CAJ | 학술논문

目的：了解新发结核病患者的各类临床特征，调查患者对结核防治知识的知晓情况，为制定针对性防控措施提供科学依据。方法回顾性分析2011年9月至2012年9月确诊的648例初诊和434例复诊肺结核患者的一般人口学特征、具体诊断信息、结核防治知晓度、用药状况等。结果结核患者以男性居多（60．2％），中青年仍是结核发病的最主要人群（77．8％），发病地区以农村为主（61．6％），职业中以体力劳动者（65．4％）居多，结核类型中以继发性肺结核居多（72．8％），40．0％（52／130）的结核型胸膜炎合并有肺结核。结核常合并尘肺（8．0％）、糖尿病（3．6％）、哮喘（4．3％）等基础疾病。初诊结核患者对结核防治问题知晓情况差异较大，但普遍偏低。复诊结核患者比初诊患者拥有更多的结核防治知识（P＜0．05）。初诊患者结核防治相关知识最主要的来源为亲友告知（30．3％），而复诊患者结核防治相关知识最主要来源为医护教育（36．9％）。不清楚疗程（45．3％）、结核症状消失（30．8％）是患者不规律用药的主要原因。结论农村等经济条件较差地区、以体力劳动为主的中青年男性是结核的主要发病人群。初诊结核患者对结核防治知识的了解程度普遍较低。综合医院在复诊患者结核知识来源中发挥重要作用，在宣传教育过程中，应就结核的传播方式、预防措施、治疗疗程、不良反应监测、免费药物发放、结核预后等目前知晓率低的知识点进行重点关注。
목적：료해신발결핵병환자적각류림상특정，조사환자대결핵방치지식적지효정황，위제정침대성방공조시제공과학의거。방법회고성분석2011년9월지2012년9월학진적648례초진화434례복진폐결핵환자적일반인구학특정、구체진단신식、결핵방치지효도、용약상황등。결과결핵환자이남성거다（60．2％），중청년잉시결핵발병적최주요인군（77．8％），발병지구이농촌위주（61．6％），직업중이체력노동자（65．4％）거다，결핵류형중이계발성폐결핵거다（72．8％），40．0％（52／130）적결핵형흉막염합병유폐결핵。결핵상합병진폐（8．0％）、당뇨병（3．6％）、효천（4．3％）등기출질병。초진결핵환자대결핵방치문제지효정황차이교대，단보편편저。복진결핵환자비초진환자옹유경다적결핵방치지식（P＜0．05）。초진환자결핵방치상관지식최주요적래원위친우고지（30．3％），이복진환자결핵방치상관지식최주요래원위의호교육（36．9％）。불청초료정（45．3％）、결핵증상소실（30．8％）시환자불규률용약적주요원인。결론농촌등경제조건교차지구、이체력노동위주적중청년남성시결핵적주요발병인군。초진결핵환자대결핵방치지식적료해정도보편교저。종합의원재복진환자결핵지식래원중발휘중요작용，재선전교육과정중，응취결핵적전파방식、예방조시、치료료정、불량반응감측、면비약물발방、결핵예후등목전지효솔저적지식점진행중점관주。
Objective To learn the various clinic characteristics of newly T tuberculosis (TB) patients ,investigating the preven-tion and treatment knowledge of TB patients ,in an effort to provide scientific evidence for targeted prevention and control meas-ures .Methods Retrospectively analyzing the common demographic characteristics of 648 newly and 434 old TB patients from Sep-tember 2011 to September 2012 ,diagnostic information ,the awareness on the prevention and treantment ,drug use situation and so on .Results Among these patients ,most of them were males(60 .2% ) ,the middle age and the young were the majority (77 .8% ) , the disease areas were mainly rural ones (61 .6% ) ,and manual workers (65 .4% ) ,secondary pulmonary TB was in the majority (72 .8% ) ,40 .0% (52/130) of the patients with TB pleuritis were accompanied by pulmonary TB .TB patients usually combined with pneumonoconiosis(8 .0% ) ,diabetes(3 .6% ) ,asthma(4 .3% ) and some other fundamental diseases .The old TB patients had more prevention and treatment knowledge about TB than those newly patients (P<0 .05) .The major source of newly patients about the knowledge were mainly from their relatives and friends (30 .3% ) ,whereas the old patients from teaching of medical care (36 .9% ) .The main reasons for irregular usage of medicine came from the lack of knowledge about the course period of treatment (45 .3% ) ,and the disappearing of TB symptoms (30 .8% ) .Conclusion In the less developed rural areas ,the young and middle aged males who mainly done physical work were the majority patients .These newly patients have little prevention and treatment knowledge about TB .Comprehensive hospitals played an important role in transmission of TB knowledge .In the process of educa-tion ,we should pay special attention on the following less known but essential points :mode of transmission ,protective measures , course period of treatment ,monitoring side effect ,giving out free medicine ,and the prognosis of TB .