Sasaki Y, Yamagishi F, Suzuki K
Division of Thoracic Disease, National Chiba-Higashi Hospital, Japan.
Kekkaku. 1995 Jan;70(1):49-55.
The incidence of tuberculosis has reduced in Japan, but the slowing down in the rate of decrease of the incidence was pointed, and this tendency is a severe problem in the tuberculosis control. Tuberculosis is considered as a disease of the past, and patient's delay and doctor's delay have gotten very long. The risk of infection with other people is on the increase, consequently, that is one of the causes of the slowing down in the rate of decrease of the incidence. The purpose of this study is clearing up the problems of patient's and doctor's delay, investigating 1274 patients diagnosed as pulmonary tuberculosis in our hospital for five years. In the cases detected their symptomatic visit and received primary treatment of tuberculosis, the alive cases, when they released from our hospital, were 584 cases. In the cases, some cases, who went to a hospital soon after they felt some symptoms, tended to not be diagnosed as pulmonary tuberculosis in their early stage. Other cases, who didn't go to a hospital until they had severe symptoms, tended to be diagnosed as pulmonary tuberculosis promptly. So, finally, total delay tended to be very long. We pointed out some cases, who detected by health check and neglected their visit to any hospitals, and after long times, went to hospitals with symptoms. They were the source of pulmonary tuberculosis to other people. And they didn't have sufficient family contact examination. In the dead cases, 47 cases were died of pulmonary tuberculosis, and their term of hospitalization was very short and their status were extremely severe.(ABSTRACT TRUNCATED AT 250 WORDS)
日本的结核病发病率有所下降,但发病率下降速度放缓的情况已被指出,这种趋势在结核病控制中是一个严重问题。结核病被认为是一种过去的疾病,患者的延误和医生的延误时间变得很长。与他人感染的风险在增加,因此,这是发病率下降速度放缓的原因之一。本研究的目的是理清患者和医生延误的问题,对我院五年内诊断为肺结核的1274例患者进行调查。在那些出现症状后就诊并接受结核病初级治疗的病例中,我院出院时仍存活的病例有584例。在这些病例中,一些在出现症状后很快就医的病例,在早期往往未被诊断为肺结核。而其他直到出现严重症状才就医的病例,往往很快被诊断为肺结核。所以,最终总的延误时间往往很长。我们指出了一些通过健康检查发现但未去任何医院就诊,很久之后出现症状才去医院的病例。他们是其他人感染肺结核的源头。而且他们没有进行充分的家庭接触检查。在死亡病例中,47例死于肺结核,他们的住院时间很短,病情极其严重。(摘要截选至250字)