2010～2014年中国粤东地区城乡结合部医院急诊颅脑CT检查应用趋势分析

摘要

目的 回顾分析中国粤东地区城乡结合部医院急诊科颅脑CT检查应用的现状,探讨颅脑CT检查阳性率的变化趋势和可能原因.方法 统计2010~2014年中国粤东地区汕头大学医学院第二附属医院急诊科患者40736例的CT检查资料,分析应用CT检查的患者性别、年龄、检查时间以及颅脑CT检查阳性结果的趋势.结果 2010~2014年,急诊科CT检查总例次呈逐步增长趋势;其中颅脑CT占比例最多,其数量5年增长27.75%,每年平均增长5.56%.其中,男性较女性多,青壮年(18~45岁)最多.但颅脑CT结果阳性率却持续在低水平,5年平均阳性率为13.58%,呈相对下降趋势,其阳性率具有差异性(P<0.001,α=0.05).阳性结果中,颅内血肿最多,其次为蛛网膜下腔出血、脑挫伤、颅骨骨折以及脑梗死.结论 急诊颅脑CT阳性率下降,给患者和医保系统增加了负担,同时也增加了患者辐射暴露的危害,该现象可能与医患关系、医保制度密切相关.%Objective To analyze the trends of craniocerebral CT application in the rural-urban fringe zone hospital in Eastern Guangdong of China.Methods The gender,age,date and trends to positive result of craniocerebral CT of 40,736 patients who had visited the Department of Emergency of the 2nd Affiliated Hospital of Shantou University Medical College from 2010-2014 were collected and analyzed.Results The total number of CT examination in our Emergency Department showed a gradual growth from 2010 to 2014.The craniocerebral CT was most often applied,which increased gradually by 27.75% during 2010-2014 and increased by 5.56% annually.The male patients were more than females,and the number of patients aged 18-45 were the largest.However,the positive rate of craniocerebral CT were relatively low (average by 13.58%),showing a trend of decreasing during the past 5 years(P<0.001,α=0.05).The intracranial hematoma or hemorrhage was the most among all the positive results,followed by subarachnoid haemorrhage,brain contusion,fracture of skull and cerebral infarction.Conclusion The positive rate decrease of the craniocerebral CT of emergency increases the burden of the patients and health care system;meanwhile,it increases the patients' radiation exposure,which may be closely related to the doctor-patient relationship and medical care system.