云南省3家综合医院感染科住院肝脏疾病患者流行情况的多中心回顾性分析

摘要

目的 研究综合医院感染科肝病住院患者疾病谱的构成特点,以期为感染科建设和临床资源配置提供参考.方法 收集2010年1月至2015年12月在3家综合医院感染科第1次住院患者病例资料进行回顾性分析.进一步对住院患者中病毒性肝炎(甲、乙、丙、戊型)、重症肝病(重型肝炎、肝硬化、肝癌)患者的分布情况进行分析.计量资料采用方差分析,计数资料用率表示,采用x2检验.不同年份疾病构成比变化情况采用x2趋势检验. 结果 云南地区3家综合医院感染科住院患者中肝病、结核病、获得性免疫缺陷综合征3种疾病占58.61％,但肝病患者(17.25％,3 555/20 606,95％CI:16.73％～ 17.77％)显著低于结核病患者33.98％(7 002/20 606,95％ CI:33.34％ ～ 34.62％),不同医院和不同时间点的观察结果均显示肝病患者比例低于结核病患者.肝病住院患者构成比呈现下降趋势(P＜0.01),其中乙型肝炎患者构成比呈下降趋势(P＜0.01),丙型肝炎和重症肝病患者构成比有逐年上升趋势(P值均＜ 0.01).结论 云南地区综合医院感染科住院肝病患者比例低于结核病患者,感染科的建设和医疗资源配置应该充分考虑这一疾病谱特点.%Objective To study the constitutional features of diseases spectrum of inpatients with liver disease in infectious diseases department of three comprehensive hospitals to provide resource allocation proposition for the construction of Department of Infectious Diseases.Methods Inpatients data were extracted from the department of infectious diseases of three comprehensive hospitals (Kunming General Hospital of the People's Liberation Army,Yuxi People's Hospital and Dali People's Hospital) between January 2010 to December 2015,and were retrospectively analyzed.The distribution of patients with viral hepatitis (A,B,C,E) and severe liver disease (Severe hepatitis,cirrhosis,liver cancer) was further analyzed in hospitalized patients.Data were analyzed by one-way analysis of variance.A chi-squared test was used for comparison between groups.The change trends of disease constituent ratio in different years were checked by 2 test.Results Liver disease,tuberculosis and AIDS were the three common diseases of three comprehensive hospitals in Yunnan,accounting for 58.61％ of all admissions.However,an inpatients with liver diseases (17.25％,3555/20606,95％ CI 16.73％-17.77％) were significantly lower than tuberculosis inpatients (33.98％,7002/20606,95％ CI 33.34％-34.62％).An observations from different hospitals and at different time points showed that the proportion of patients with liver disease was lower than that of tuberculosis patients.The proportion of inpatients with HBV infection showed a downward trend (P ＜ 0.001),whereas the proportions ofinpatients with HCV and severe liver diseases showed an increased trend over time (P ＜ 0.001).Conclusion The proportion of inpatients with liver diseases was lower than tuberculosis inpatients in the Department of Infectious Diseases of three comprehensive hospitals.Hence,the paucity of the disease spectrum should be considered for resource allocation in the construction of infectious disease department.