Med Clin (Barc). 2001 Feb 10;116(5):167-73.
To analyze clinical practice regarding tuberculosis in Spain.
After active search in 14 registries, cases of tuberculosis were identified in 13 autonomous regions, representing almost 67% of the total Spanish population. The study period was May 1996-April 1997.
10,053 cases were identified. Almost 80% were diagnosed at the hospital and most of the patients (91.7%) were symptomatic. Median patient delay was 21 days and median delay between symptoms and treatment was 41 days. Smear and culture was performed in 82% of pulmonary cases while at least a culture was performed in 75.5% of extrapulmonary cases. 72.5% of pulmonary cases and 39.7% of extrapulmonary cases were culture positive. More than 76% of the subjects were treated with 3 drugs, generally rifampin, isoniazid and pirazinamide in agreement with Spanish guidelines; however, the information on duration of treatment was insuficient. Combined tablets were usually prescribed (86.8% of patients) and use of DOT was scarce (5.4% of cases). The information on contact investigation was poor.
Diagnostic and treatment practices regarding tuberculosis have clearly improved in Spain, but patient management has still to improve.
分析西班牙关于结核病的临床实践情况。
在14个登记处进行积极检索后，在13个自治区确定了结核病病例，这些自治区的人口几乎占西班牙总人口的67%。研究时间段为1996年5月至1997年4月。
共确定了10053例病例。近80%的病例在医院被诊断出，大多数患者（91.7%）有症状。患者的中位延迟时间为21天，症状出现至治疗的中位间隔时间为41天。82%的肺结核病例进行了涂片和培养，而75.5%的肺外结核病例至少进行了一次培养。72.5%的肺结核病例和39.7%的肺外结核病例培养呈阳性。超过76%的患者接受了三种药物治疗，通常是根据西班牙指南使用利福平、异烟肼和吡嗪酰胺；然而，关于治疗持续时间的信息不足。联合片剂通常被开出处方（86.8%的患者），直接观察治疗（DOT）的使用很少（5.4%的病例）。关于接触者调查的信息较差。
西班牙关于结核病的诊断和治疗实践有了明显改善，但患者管理仍有待改进。
