2017年-2018年某院耳鼻咽喉科住院儿童疾病构成分析

Analysis of Disease Composition of Inpatients in Otolaryngological Ward of a Hospital from 2017 to 2018

目的分析某院耳鼻咽喉科住院儿童主要疾病构成分布情况及手术率等医疗效率指标,为耳鼻咽喉科疾病的防治与学科建设提供可靠依据。方法回顾性分析2017年1月1日-2018年12月31日沈阳市某三级甲等医院耳鼻咽喉病房近2年收治的14441例儿童住院病案首页资料,收集患者的性别、年龄、疾病主要诊断、主要手术和操作、住院天数和住院费用等信息进行统计分析。结果排名前20位疾病病种人数占比为96.76%,平均住院日6.07天。男女患儿性别比为1.62:1。构成比最高的前3位疾病依次为腺样体肥大(41.56%)、慢性扁桃体炎伴腺样体肥大(29.21%)和睡眠呼吸暂停低通气综合征(12.91%),累计构成比为83.67%。5岁以下儿童的食管异物(χ~2=58.308,P<0.001)、气管异物(χ~2=103.938,P<0.001)、耳道异物(χ~2=10.180,P<0.001)、鼻内异物(χ~2=47.903,P<0.001)和支气管内异物(χ~2=18.655,P<0.001)构成比显著高于5岁~14岁儿童。5岁~14岁儿童的鼻骨骨折(χ~2=77.006,P<0.001)构成比显著高于5岁以下儿童。前3位病种的平均手术率为95.98%。结论耳鼻咽喉科住院患儿病种高度集中,手术率高。5岁以下儿童呼吸道异物比例较高,5岁~14岁儿童鼻骨骨折比例较高,应重点加强儿童腺样体肥大、慢性扁桃体炎伴腺样体肥大和睡眠呼吸暂停低通气综合征等耳鼻咽喉科重点疾病的医疗工作,促进耳鼻咽喉病房学科建设。

Objectives To analyze the distribution of major diseases and the medical efficiency index such as operation rate of hospitalized children in otorhinolaryngology department of a hospital,so as to provide reliable basis for prevention and treatment of Otolaryngology diseases and discipline construction.Methods The data of 14441 children hospitalized in the otolaryngologicalward of a Three A and TertiaryHospital in Shenyang from January 1 st,2017 to December 31 st,2018 were retrospectively analyzed.The data of gender,age,main diagnosis,main operation,length of stay and hospitalization expenses were collected and analyzed.Results The proportion of the top 20 diseases in otolaryngology was 96.76%,with an average hospitalization time of 6.07 days.The sex ratio of male to female was 1.62:1.The top three diseases with the highest constituent ratio were adenoidal hypertrophy(41.56%),chronic tonsillitis with adenoidal hypertrophy(29.21%)and sleep apnea hypopnea syndrome(12.91%).The cumulative constituent ratio was 83.67%.The proportion of esophageal foreign bodies(χ~2=58.308,P<0.001),tracheal foreign bodies(χ~2=103.938,P<0.001),auditory foreign bodies(χ~2=10.180,P<0.001),intranasal foreign bodies(χ~2=47.903,P<0.001)and intrabronchial foreign bodies(χ~2=18.655,P<0.001)in children under 5 years old were significantly higher than those in children between 5 and 14 years old.The proportion of nasal bone fracture(χ~2=77.006,P<0.001)in children aged 5-14 was significantly higher than that in children under 5 years old.The average surgical rate of the top 20 diseases was 95.98%.Conclusions Otolaryngology hospitalized children were highly concentrated and had a high surgical rate.The proportion of foreign body in respiratory tract of children under 5 years old was higher,and the proportion of nasal bone fracture of children between 5 and 14 years old was higher.It was necessary to strengthen the medicaltreatment of key diseases in otorhinolaryngology,such asadenoid hypertrophy,chronic tonsillitis with adenoid hypertrophy and sleep apnea hypopnea syndrome,so as to promote the discipline constructionofotorhinolaryngology ward.