Răduţă M
Spitalul Clinic de Pneumologie Leon Daniello, Cluj-Napoca.
Pneumologia. 2001 Jul-Sep;50(3):159-66.
Starting with the premise of preventing tuberculosis by watching the epidemiological succession (earliest discovery and medical attendance of new cases, interception of the transmitting ways by annihilating the hotbed and measures taken for the contacts, strengthening the specific resistance by the BCG vaccination and sanitary education) we have analyzed the application of these measures in adult cases, both bacteriologically confirmed (M+C+, M-C+) between 1995-2000 and found in those 280 contact children after the epidemiological investigation in Cluj-Napoca. The TSS/DOTS correctly and completely applied, no matter the place of application (hospital or ambulatory treatment) has drawn to a 75% rate of healings and debacillations in adults and to over 90% in children. Chronics and deaths have been registered in adults only through unconformity to treatment (failure + abandon + lost). The measures applied to the contacts were correct, finding out children with only the benign type of tuberculosis and, exceptionally only, (1%) with more severe forms, no deaths being registered in this period. The measures applicable to the home hotbed, the sanitary education as well as the protective measures of the sanitary medical staff, employed to supervise and control tuberculosis admits improvement still being far from the theoretic ideal.
从通过观察流行病学连续过程预防结核病的前提(新病例的最早发现和医疗救治、通过消除传染源阻断传播途径以及对接触者采取措施、通过卡介苗接种和卫生教育增强特异性抵抗力)出发,我们分析了这些措施在1995 - 2000年间经细菌学确诊的成年病例(痰菌阳性+培养阳性、痰菌阴性+培养阳性)中的应用情况,并在克卢日 - 纳波卡进行流行病学调查后,对280名接触儿童进行了研究。无论应用地点(医院或门诊治疗)如何,正确且全面应用的TSS/DOTS方案在成人中实现了75%的治愈和菌阴转率,在儿童中超过了90%。仅在成人中因治疗不规范(失败+放弃+失访)出现了慢性病和死亡病例。对接触者采取的措施是正确的,仅发现患有良性肺结核类型的儿童,极少数(1%)患有更严重的类型,在此期间未登记有死亡病例。适用于家庭传染源的措施、卫生教育以及卫生医务人员用于监督和控制结核病的防护措施仍有待改进,距离理论理想状态仍有很大差距。