Mucke H, Mucke T
Poliklinische Abteilung für Lungenkrankheiten und Tuberkulose, Dessau, DDR.
Z Erkr Atmungsorgane. 1990;174(3):196-203.
In the GDR annually repeated indiscriminate mass miniature radiographies (MMR) of all persons in the age of 16 years and over were performed during 3 decades. The aim was, beside finding cases of pulmonary tuberculosis, the early detection of bronchogenic carcinoma. The decrease of tuberculosis incidence and the shift of nearly all new cases to higher age groups lead to a change of this policy. The new regulation, in force since 1986, provides mass X-ray examinations of all persons in the age of 40 years and over with 2 years interval, and X-ray examinations of the lung of persons in several risk groups with shorter, mainly annual intervals. The latter became a task of the chest clinics. The experience of 2 chest clinics with the organization of these examinations and the yield of new cases of pulmonary tuberculosis and bronchogenic carcinoma are reported. It is necessary to improve the organization and to reduce the number of risk-groups to those with an acceptable balance of input and result. Otherwise, the staff of the chest clinics is impeded to fulfill more rewarding tasks in the care of patients. The results of the attempts of early detection of bronchogenic carcinoma and improvement of life expectancy by X-ray examination of risk groups and early resection were disappointing. Thus, other ways must be found. A revision of the regulation of 1986, concerning risk groups, is proposed with the aim to rationalize their surveillance.
在民主德国,三十年间每年对所有16岁及以上人群进行反复的无差别大规模微型X光摄影(MMR)。其目的除了发现肺结核病例外,还包括早期检测支气管源性癌。肺结核发病率的下降以及几乎所有新病例向更高年龄组的转移导致了这一政策的改变。自1986年起生效的新规定要求对所有40岁及以上人群每两年进行一次大规模X光检查,对几个风险组的人群进行间隔更短(主要是每年一次)的肺部X光检查。后者成为了胸科诊所的一项任务。本文报告了两家胸科诊所在组织这些检查方面的经验以及肺结核和支气管源性癌新病例的检出率。有必要改进组织工作,并将风险组的数量减少到那些投入与结果平衡可接受的组。否则,胸科诊所的工作人员将无法完成在患者护理方面更有意义的任务。通过对风险组进行X光检查和早期切除来早期检测支气管源性癌并提高预期寿命的尝试结果令人失望。因此,必须寻找其他方法。本文提出了对1986年关于风险组规定的修订,旨在使其监测合理化。