18613例急诊科患者流行病学特点及疾病谱构成

摘要

目的：探讨2013年本院急诊科18613例患者的流行病学特点及疾病谱构成。方法回顾性分析2013年1月至2013年12月本院急诊科门诊患者的基本资料，总结其流行病学特点，分析此期急诊科门诊疾病谱构成。采用ICD-10进行疾病分类。结果入选病例18613例，平均年龄44(29～60)岁，高峰年龄36～50岁；其中死亡34例，内科住院率18.4%，外科住院率13.9%；男：女比为1.2：1，女性患者外科住院率远低于男性；随着年龄增长，内科住院率逐渐增多；晚上（18：00～23：59）接诊病例数占首位，接诊高峰时间为18：00～21：59，低谷时间为4：00～5：59，上午（6：00～11：59）的内科住院率最高；伤害和中毒疾病、消化系统疾病及呼吸系统疾病居就诊病因的前三位；女性患者伤害和中毒疾病较男性少，神经系统疾病较男性多；老年组（51～70岁）及高龄组（71～97岁）患者神经系统及循环系统疾病高于其余年龄组。结论①可根据患者的流行病学特点加强急诊科人员在数量及时间上的合理配置；②根据疾病谱构成可对医务人员进行重点培训，以提高本院急诊医疗水平；③重视男性的安全防范教育、女性的心理卫生教育及老年人的疾病预防宣教。%Objective To discuss the epidemiological characteristics and disease spectrum composition of 18 613 patients from the emergency department in our hospital in 2013. Method A retrospective analysis of information of the outpatients from emergency department in our hospital from January 2013 to December 2013 was performed to summarize their epidemiological characteristics and to analyze their disease spectrum composition in this period. ICD-10 was used for the disease classification. Result A total of 18 613 patients were enrolled for analysis with a median age of 44(29~60) and a peak age from 36 to 50, of which 34 died. The medical hospitalization rate(MHR) was 18.4%and the surgical hospitalization rate(SHR) was 13.9%. The ratio of male to female was 1.2:1. The SHR in female was far less than that in male. However,the MHR has been increasing as patients’age grows. The number of cases at night(from 18:00 to 23:59)was the largest.The peak time was from 18:00 to 21:59 and the non-peak time was from 4:00 to 5:59. The MHR was the highest in the morning. Injury and poisoning diseases, digestive system diseases and respiratory system diseases were the top three of the pathogeny. The number of female patients suffering from injury and poisoning diseases was less than the male ones, while the number of female patients with nervous system diseases was more than the male ones. The cases of nervous and circulation system diseases in old-age group(51~70 years old) and elder-age group(71~79 years old) were more than the others. Conclusion The emergency medical services can be improved by strengthening the reasonable allocation of manpower resource in the emergency department regarding number and time according to the epidemiological characteristics;training medical workers on the basis of the disease spectrum composition;focusing on the saftety education to men and the psychological guidance to women,and enlarging the publicity of disease prevention among the elderly.