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钟南山:近半国人携带结核杆菌
双击自动滚屏 发布者:admin 发布时间:2010/4/6 9:51:05 阅读:41926次 【字体:

全国共有450万活动性结核病人,带菌者高达5.5亿。

1850-1950 全球死于结核病的人共10亿。当人们不再把结核病当一回事的时候,全国人大代表、中国工程院院士钟南山在接受一次采访中表示,全国共有450万活动性结核病人,带菌者高达5.5亿。

更严重的是,结核病中的广泛耐药结核病,几乎对目前所有的抗结核药都产生耐药性,如果得上这种病,医生目前基本无能为力!

昨天记者从省市疾控中心得到数据,我省每年新发耐多药结核病人2100例,直接的疾病经济负担高达6000万元,发病以青壮年流动人口为主,目前我省一线药物和部分检查都已免费,且大部分治疗药物纳入医保。尽管如此,由于报销比例不高,患者个人负担仍然很重。

如果广泛耐药结核病得不到控制,人类将被带回面对结核病几乎束手无策的时代。

结核病远比想象中危险:除了头发和指甲 结核菌会在全身疯长

也许是“肺痨”这个词的影响,不少人印象中,结核病就是指肺结核,事实并非如此。

杭州市的结核病治疗中心设在市红会医院,这两天,大家都在谈论一位上虞的结核病人。

结核科李凫坚主任说:“半年前,小伙子被发现右下腹有结核病灶,仅3个月后,他的核磁共振检查结果就显示,他的颈椎、胸椎、腰椎、骶椎,还包括胸骨和肋骨,都遭到了结核菌的破坏。两节腰椎骨已经呈90度弯曲。”

“结核病一般青壮年多发(据杭州市疾控中心统计,结核病人中15-54岁的占了68.75%),有的人皮肤上长红斑,有的人关节痛,有的人长期低烧,2/3的结核病都不太典型。”胸外科主任徐旭东主任说,结核菌通过呼吸道吸入体内后,会在所有有血流的地方生长,“除了指甲和头发,其他地方都会长结核,如果眼睛长了角膜结核,就会失明。”

结核病会继发癌症

结核病是所有传染病当中死亡率最高的疾病,2000年的流行病学调查显示,我国有200万人因为感染结核病而死亡。

而在生活中,大部分人都感染过结核菌。红会医院的三位医生在临床检查中发现,70%的病人结核皮试呈阳性(即感染结核菌)。

“结核病灶如果不治疗,可能继发癌症”,徐旭东主任说,这样的病人,他每年都能碰到。

耐多药结核病患者基本无药可治

萧山的陈大伯今年70多岁,8年前得了肺结核,因为各种原因,中间断断续续服药多年。去年3月,他被诊断为耐多药结核病,目前的药物对他已不起作用了。

2009年4月,世卫组织在北京召开“耐多药、广泛耐药结核病高负担国家部长级会议”,来自会议的数据显示,我国每年新发耐多药肺结核患者12万例(估算),广泛耐药发病率则为0.68%,总计大约为1万人。

世卫组织总干事陈冯富珍表示,如果广泛耐药结核病得不到控制,人类将被带回面对结核病几乎束手无策的时代。

今年“两会”上,全国人大代表、南开大学医学院教授朱天慧提交《关于将多药耐药结核病纳入补充医疗保险的议案》,呼吁不管是初治结核病还是耐药、广泛耐药结核病的治疗费用,都应该纳入国家免费治疗的范围内。

但由于流动人口结核病占结核病人总数的27.53%,其中又以农民、民工、工人为主,对他们来说,负担依然很重,杭州市疾控中心结核病防治所吴琍敏所长说。

如果是单纯的结核病,没有肺部感染,治疗很顺利,每月治疗费用一两百元,6个月治疗结束总花费约1500—2000元,但这样状况良好病人很少。大部分患者都是已经出现咯血才来就诊,肺部已经感染,许多耐药性的治疗期需2年,要用二线药物和辅助药物,而这些药就需要自费,治好至少要花4万元。

5市患者可申请基金救助

为尽早治疗,避免病人结核病产生耐药性,我省于2007年成功争取到全球基金结核病控制项目,该项目从2008年10月开始覆盖我省杭州、湖州、绍兴、衢州和丽水5个市。

上述5市所属各县(市、区)的耐药结核病可疑患者,可到当地结核病定点医院或疾控中心检查治疗,只要被确认纳入项目的病人,就可享受免费检查,并免费享受二线抗结核药治疗机会。除此之外,项目基金还会根据具体情况,为经济特别困难的病人提供适当的营养和交通补助费。

应对结核病你可以做到

不“遵医嘱”、经常停服药或中断治疗是耐药结核病产生的主要原因,因此,一旦患上结核病,切忌随意中断治疗。

结核病人吐一口痰,干燥后的结核菌会漂浮在空气中,在太阳下能存活2小时,在阴暗潮湿的环境中可以存活数十年。

“许多人在咳嗽或是打喷嚏时,都会以双手来掩住口鼻。但从防疫观点来看,这是错误的,因为双手很可能沾染了结核病菌”,红会医院结核科李主任说,“在西方国家,人们已经养成了用手肘衣袖来捂嘴巴的习惯,因为很少有人会碰你的手肘,这里相对比较干净。”

摘自《青年时报》

 
 

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