Sasaki Y, Yamagishi F, Suzuki K, Yagi T, Miyazawa H, Shirai T, Satoh N, Tougoh N, Ihara S
Division of Thoracic Disease, National Chiba-Higashi Hospital, Japan.
Kekkaku. 1993 Feb;68(2):85-9.
This study investigates 27 cases in which the patients left hospital care without permission for personal reasons. These patients were classified as "self-discharged patients". Each of the patients had been diagnosed as having pulmonary tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital during the period from January 1988 to July 1991. Disease was in an advanced stage in each of the patients when admitted: all sputum examinations were positive and chest roentgenograms revealed cavities in 26 patients. In addition to pulmonary tuberculosis, the patients were also diagnosed has having a variety of other medical complications such as diabetes mellitus, gastric ulcers and liver disease. Many of them were unemployed or were day labors. Reasons attributed to patients self-discharge from the hospital included repetition of alcohol drinking and unauthorized outings. At the time patients chose to leave hospitalization 11 cases checked positive for sputum examinations, and 16 cases never returned to complete therapy. Many of them were rated as high risk patients for pulmonary tuberculosis because they had no immediate family, did not own a residence or have regular employment thus economic and psychological conditions were very low. There is a high possibility that these individuals will suffer pulmonary tuberculosis relapse and become infectious bacteria carriers. It is important that such patients be hospitalized long enough to receive adequate treatment to prevent then from becoming infectious carriers and spreading disease.
本研究调查了27例因个人原因未经许可擅自离院的患者。这些患者被归类为“自动出院患者”。每位患者均被诊断患有肺结核，并于1988年1月至1991年7月期间在千叶东医院接受治疗。患者入院时病情均处于晚期：所有痰液检查均呈阳性，26例患者的胸部X光片显示有空洞。除肺结核外，这些患者还被诊断患有多种其他医学并发症，如糖尿病、胃溃疡和肝病。他们中的许多人失业或为日工。患者自动出院的原因包括酗酒和擅自外出。患者选择离院时，11例痰液检查呈阳性，16例未返回完成治疗。他们中的许多人被评为肺结核高危患者，因为他们没有直系亲属、没有住所或固定工作，因此经济和心理状况很差。这些人很有可能肺结核复发并成为传染性细菌携带者。重要的是，此类患者应住院足够长的时间以接受充分治疗，以防止他们成为传染性携带者并传播疾病。
