17970例骨科住院患者疾病构成的帕累托图分析

Pareto Chart Analysis of 17970 Cases of Orthopedic Inpatients

目的 分析某三甲医院骨科住院患者的疾病构成,为骨科常见疾病防治提供依据.方法 调取某三甲医院电子病历系统中骨科住院患者的病例资料,依据国际疾病分类(ICD-10)对出院主要诊断编码,使用Access2010整合和清理原始数据,采用Excel绘制疾病死因的帕累托图,采用SPSS 24.0进行统计学分析,采用χ2检验和Trend-χ2检验分析构成比变化的趋势.结果 骨科住院患者疾病排名前5位的病种依次是肱骨髁上骨折(6.33%)、腰椎间盘突出(5.95%)、颈椎病(3.04%)、髋关节脱位(2.77%)、股骨干骨折(2.70%).疾病谱趋势分析显示股骨干骨折男性患者比例显著高于女性,分别是3.20%与1.98%;而腰椎间盘突出、髋关节脱位女性患者比例显著高于男性,分别是6.81%与5.30%、4.74%与1.33%;腰椎间盘突出和颈椎病随年龄增长而呈升高趋势.肱骨髁上骨折、髋关节脱位和股骨干骨折多发于<10岁年龄组,随年龄增长而呈下降趋势.结论 男性和女性骨科疾病谱分布不同,腰椎间盘突出和颈椎病类骨科慢性病随年龄增长而增多,肱骨髁上骨折、髋关节脱位和股骨干骨折是10岁以下孩童防治重点.

Objectives To analyze the disease composition of patients in orthopedic wards of a Three A and Tertiary Hospital,and provide data support for prevention and treatment of orthopedic diseases.Methods To obtain the medical cases of hospitalized patients in orthopedic department of a Three A and Tertiary Hospital,discharge the main diagnostic code according to the International Classification of Diseases(ICD-10),integrate and clean up the primary data with the Access 2010,draw the Pareto chart of disease causes of death by Excel,using SPSS 24.0 make statistical analysis,theχ2 test and Trend-χ2 test were applied to analyze the change trend of composition ratio.Results Among the patients admitted to the orthopedic ward,the top 5 diseases were supracondylar fracture of humerus(6.33%),lumbar disc herniation(5.95%),cervical spondylosis(3.04%),dislocation of hip joint(2.77%),and femoral shaft fracture(2.70%).The trend analysis of disease spectrum showed that the proportion of male patients with femoral shaft fracture was significantly higher than that of female patients,3.20%and 1.98%respectively.The proportion of female patients with lumbar disc herniation and hip dislocation was significantly higher than that of male patients,6.81%and 5.30%,4.74%and 1.33%respectively.Lumbar disc herniation and cervical spondylosis showed an upward trend with the increase of age.Supracondylar fracture of humerus,dislocation of hip joint and fracture of femoral shaft are most common in under 10 years old age group.Conclusions Male and female orthopedic disease spectrum distribution were different,lumbar disc herniation and cervical spondylosis orthopedic chronic diseases were increasing with age,humerus supracondylar fracture,hip dislocation and femoral shaft fracture were the focus of prevention and treatment for children under 10 years old.