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alt="我國(guó)肺結(jié)核屬于哪類(lèi)法定報(bào)告?zhèn)魅静?/></p><p>　　根據(jù)世界衛(wèi)生組織公布的2015年全球結(jié)核病報(bào)告，2014年結(jié)核病在全球范圍奪去了150萬(wàn)人的生命，估算全球2014年有960萬(wàn)新發(fā)結(jié)核病病例，同時(shí)估算中國(guó)2014年的新發(fā)肺結(jié)核人數(shù)為93萬(wàn)，位列印度(220萬(wàn))和印度尼西亞(100萬(wàn))之后，為全球第三。</p><p>　　在接受采訪(fǎng)時(shí)，上海市疾病預(yù)防控制中心結(jié)核病防治科主任沈鑫表示，在中國(guó)37種法定報(bào)告的甲乙類(lèi)傳染病中，結(jié)核病的發(fā)病人數(shù)居第二位，死亡人數(shù)也居第二位;在上海，結(jié)核病發(fā)病人數(shù)居第三位，死亡人數(shù)則排在傳染病第一位。</p><p><strong>　　“十癆九死”</strong></p><p>　　“解放前，有句老話(huà)叫‘十癆九死’，講的就是肺結(jié)核的病人多、死亡率高�，F(xiàn)在，大家也許很少聽(tīng)到肺結(jié)核，其實(shí)它離我們并不遙遠(yuǎn)�！鄙蝣胃嬖V澎湃新聞?dòng)浾�，雖然在上海結(jié)核病的患病率已經(jīng)由20世紀(jì)50年代的十萬(wàn)分之四千，減少到十萬(wàn)分之四十。但在中國(guó)37種法定報(bào)告的甲乙類(lèi)傳染病中，結(jié)核病排在第二位，僅次于病毒性肝炎。在上海結(jié)核病發(fā)病人數(shù)在傳染病中排第三位，約占20%，僅次于梅毒和淋病。</p><p>　　沈鑫說(shuō)，雖然結(jié)核病發(fā)病人數(shù)不是排在首位，但在上海因甲乙類(lèi)傳染病死亡的人數(shù)中，90%是因結(jié)核病死亡，“雖然結(jié)核病的治愈率也已經(jīng)達(dá)到85%，但是死亡人數(shù)還是比其他傳染病高得多，包括大家都非常害怕的艾滋病�！�</p><p>　　結(jié)核病有記載的歷史可以追溯到六千年前的意大利和埃及，結(jié)核桿菌是全世界最主要的致命傳染病之一，到目前也沒(méi)有一個(gè)國(guó)家消除過(guò)結(jié)核病。中國(guó)是結(jié)核病大國(guó)，1973年湖南長(zhǎng)沙馬王堆一號(hào)墓出土的2100年前的女尸肺上部及左肺門(mén)就發(fā)現(xiàn)有結(jié)核鈣化灶，近代魯迅、蕭紅等均死于肺結(jié)核。</p><p>　　沈鑫表示，雖然每個(gè)人出生時(shí)醫(yī)院都會(huì)注射兩針疫苗，一針是卡介苗用于防治結(jié)核病，另一針則是乙肝疫苗，但兩者的最終結(jié)果完全不同。</p><p>　　“乙肝疫苗的保護(hù)率很好，現(xiàn)在的小朋友中，乙肝病毒的攜帶率已經(jīng)降到很低，但是卡介苗只對(duì)兒童重癥肺結(jié)核，結(jié)核性腦膜炎等有效，對(duì)普通肺結(jié)核和成年人的肺結(jié)核并沒(méi)有多大作用。全球希望研發(fā)一種新的疫苗取代卡介苗，但目前它依然是最好的�！鄙蝣握f(shuō)。</p><p>　　從全國(guó)角度來(lái)看，結(jié)核病最重要的病種是肺結(jié)核，約占結(jié)核的90%，而且也是唯一有較強(qiáng)傳染性的結(jié)核病。在2001年之前，中國(guó)結(jié)核病患者以青壯年為主，但現(xiàn)在48.8%的結(jié)核病患者是60歲以上的老年人。沈鑫告訴澎湃新聞?dòng)浾�，在上海，結(jié)核病呈現(xiàn)兩極化的趨勢(shì)，一方面青壯年患者主要集中在流動(dòng)人口中，另一方面在上海戶(hù)籍人口中患結(jié)核病的主要是老年人。</p><p><strong>　　棋牌室易成肺結(jié)核傳染場(chǎng)所</strong></p><p>　　沈鑫表示，肺結(jié)核防治的一大難點(diǎn)是，凡是患傳染性肺結(jié)核的病人，發(fā)達(dá)國(guó)家都采取隔離治療，但目前中國(guó)沒(méi)有相關(guān)法律法規(guī)可以強(qiáng)制約束病人的行為，如果病人拒絕隔離，醫(yī)生就束手無(wú)策，“因?yàn)橹挥屑最?lèi)傳染病，才會(huì)強(qiáng)制隔離，像之前的非典，而肺結(jié)核目前是乙類(lèi)傳染病�！�</p><p>　　據(jù)他介紹，因?yàn)榻Y(jié)核病的治療療程比較長(zhǎng)，至少需要6個(gè)月到8個(gè)月，同時(shí)吃至少4種藥物，因此雖然在上海結(jié)核病的治療、手術(shù)費(fèi)用全部由政府買(mǎi)單，但還是有小部分病人沒(méi)有接受正規(guī)治療，原因包括覺(jué)得藥物的`副反應(yīng)大，害怕失去工作，甚至有的是為了躲避債務(wù)。</p><p>　　不久前，沈鑫遇到過(guò)一個(gè)病例，他是一名在上海高校就讀的學(xué)生，2015年4月感到咳嗽、身體不適，但一直沒(méi)有看病，暑假回老家看病時(shí)才查出是肺結(jié)核。但是，當(dāng)時(shí)他使用了哥哥的醫(yī)�？�，因此醫(yī)院并不掌握他的實(shí)際情況。2015年9月，這名學(xué)生帶病回上海繼續(xù)上學(xué)，到10月寢室里有其他同學(xué)出現(xiàn)癥狀，并被查出肺結(jié)核。在對(duì)患者的密切接觸者進(jìn)行篩查時(shí)，有同學(xué)反映，寢室里有另一名同學(xué)每天都在偷偷吃藥，此時(shí)醫(yī)生再檢查，才發(fā)現(xiàn)這名帶病上學(xué)的同學(xué)肺里已滿(mǎn)是病灶。</p><p>　　沈鑫表示，雖然學(xué)生總體疫情低于普通人群，但若是出現(xiàn)沒(méi)有及時(shí)發(fā)現(xiàn)的情況，加上現(xiàn)在宿舍普遍使用空調(diào)，對(duì)病菌的稀釋作用差，就容易比較密集發(fā)病。肺結(jié)核的另一個(gè)易感人群是老年人，他們的發(fā)病率是普通人的兩到三倍。另外，臨床數(shù)據(jù)證實(shí)糖尿病患者易患肺結(jié)核。老年人肺結(jié)核發(fā)病率高、風(fēng)險(xiǎn)高、治療效果差、復(fù)發(fā)率高。最近的一項(xiàng)流行病學(xué)研究證實(shí)，肺結(jié)核桿菌會(huì)在同一個(gè)棋牌室的人群中傳播。</p><p><strong>　　診斷肺結(jié)核還是100年前的老方法</strong></p><p>　　肺結(jié)核的治療結(jié)果是，一部分患者會(huì)最終成功治愈，而另一部分沒(méi)有治好的患者，最終體內(nèi)結(jié)核菌會(huì)變異，并產(chǎn)生耐藥性。從流行病學(xué)角度可以分為原發(fā)耐藥和繼發(fā)耐藥，前者指從未接觸過(guò)藥物治療的病人感染的就是耐藥菌，后者則指接受藥物治療的結(jié)核病病人出現(xiàn)的結(jié)核菌耐藥。</p><p>　　讓醫(yī)生憂(yōu)慮的是耐多藥結(jié)核病患者的治愈率只有54%，而療程是長(zhǎng)達(dá)2年。沈鑫表示，對(duì)于耐多藥結(jié)核病人來(lái)說(shuō)，常用一線(xiàn)抗結(jié)核藥物不管用。這部分病人，2年內(nèi)的病死率會(huì)達(dá)到20%以上。在上海，耐多藥肺結(jié)核的診斷治療，方案全部由上海肺結(jié)核專(zhuān)家組擬定，動(dòng)用最好的醫(yī)療資源。</p><p>　　沈鑫表示，目前診斷肺結(jié)核的方法還是100年前的老方法，涂片和培養(yǎng)，通俗率地說(shuō)就是查痰里的細(xì)菌。肺結(jié)核的癥狀往往并不典型，很多人認(rèn)為只是普通感冒，自己用點(diǎn)感冒藥。</p><p>　　“使用抗生素治療兩周，一般肺炎都會(huì)有好轉(zhuǎn)或吸收，如果沒(méi)有任何效果就要考慮肺結(jié)核的可能性�！鄙蝣伪硎�，對(duì)于肺結(jié)核的防治，怎么早期發(fā)現(xiàn)、控制傳染源非常重要。上海近幾年在34家定點(diǎn)醫(yī)院投入專(zhuān)項(xiàng)資金，對(duì)實(shí)驗(yàn)室進(jìn)行標(biāo)準(zhǔn)化建設(shè)，縮短耐藥性肺結(jié)核的檢測(cè)時(shí)間。</p><p><strong>　　肺結(jié)核飲食禁忌盤(pán)點(diǎn)</strong></p><p>　　富含蛋白質(zhì)的食品</p><p>　　肺結(jié)核者身體會(huì)缺乏蛋白質(zhì)，要適當(dāng)補(bǔ)充營(yíng)養(yǎng)。食用富含蛋白質(zhì)的食品對(duì)治療疾病有益，應(yīng)多吃豆腐、豆干、豆皮等。</p><p>　　富含維生素的食品</p><p>　　維生素是人體不可或缺的營(yíng)養(yǎng)，可增強(qiáng)人體免疫力。肺結(jié)核者應(yīng)多吃富含維生素的食品，以提早自身抗病能力。在全部水果中，檸檬、蘋(píng)果、柚子、梨、橙富含維生素。</p><p>　　富含鈣、鐵的食品</p><p>　　肺結(jié)核者不適宜吃菠菜，但適宜吃富含鈣、鐵、鋅的蔬菜，比如芹菜、番茄、金針菜等。值得注意的是，富含草酸的蔬菜會(huì)影響人體鈣的吸收，不利于疾病的治療。</p><p>　　較高熱量的食品</p><p>　　雖然很多人認(rèn)為熱量高的食物對(duì)人體無(wú)意，比如煎炸油膩的食物。對(duì)于肺結(jié)核者來(lái)說(shuō)，高熱量的食物能補(bǔ)充身體的能量，彌補(bǔ)消耗的能量。熱量高的食物有桂圓干、核桃、花生等。</p><p>【我國(guó)肺結(jié)核屬于哪類(lèi)法定報(bào)告?zhèn)魅静　肯嚓P(guān)文章：</p><p><a 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