兰州市25992例院外急救患者疾病谱分析

Spectrum of diseases that need pre-hospital emergency medical care and time periods thereof： analysis of 25992 patients

目的 了解兰州院外急救多发病种及发病时段等特征。方法分析2006年1月1日。2008年1月1日兰州市呼叫“120”并实施院外救治的25992例城市及周边地区患者的临床资料。结果25992例患者中男15855例，女10137例，男：女1．56：1；年龄分布≥60岁37．51％，40～59岁29．48％，20—39岁28．98％，〈20岁4．03％。前三位疾病类型为创伤（30．85％）、神经系统疾病（16．31％）和循环系统（13．36％）。院外病死率在以下疾病类型较高：肿瘤（8．77％），其他（死因不明及转院、出院回家途中死亡患者）（6．46％）、循环系统疾病（4．95％），呼吸系统疾病（4．37％）。总的发病时段呈0～6时和18～24时两个高峰时段，各时段内发病数呈逐渐增多趋势。消化系统疾病、妇产科疾病0～6时发病高于其他时段；循环系统疾病、神经类系统疾病0～6时发病低于其他时段，其他时段差异不明显；肿瘤类疾病6-12时发病高于其他时段；中毒、创伤、理化外因、儿科类疾病18—24时发病高于其他时段。结论城市及周边地区人群中呼叫“120”的急性危重患者男性多于女性，男：女1．56：1；青中年人群占大多数（58．46％）。创伤、神经系统疾病、循环系统疾病居发病类型前三位。呼叫“120”的患者人数呈现早、晚两个高峰时段。不同类型的疾病高发时段各不相同。

Objective To investigate the spectrum of diseases that need pre-hospital treatment and the onset time periods thereof. Methods The clinical data of 25,992 patients who called the local emergency services at 120 for pre-hospital care in Lanzhou during the period 1 January 2007 to 1 January 2008. Results 15 855 males and 10 137 females were analyzed, age distribution of all patients as follows： the patients who are Older than 60 accounted for 37.51% ,40 to 59 accounted for 29.48%,20 to 39 accounted for 28.98, younger than 20 accounted for 4.03%.The top three diseases needing pre-hospital care were trauma （30.85%）, nervous diseases （16.31%）,and cerebrovaseular and cardiovascular diseases （13.36%）. The 4 top causes of pre-hospital death were tumor （8.77 % ）, other diseases （6.46 % ,Including these patients whose cause of death were unknown and transfers and died on the way to go home）, circulatory system diseases （4.95%）, and respiratory diseases （4.37%）. The incidence of disease showed an increasing trend during the following 2 time periods： from 0 o＇clock to 6 o＇clock and from 18 o＇clock to 24 o＇clock. Most of the patients with digestive diseases and gynecological and obstetric diseases appeared in the time period of 0-6 am. The numbers of nervous diseases and cerebrovascular and cardiovascular diseases were the least during 0-6 am, and were not significantly different during the other time periods. Most of the tumor cases appeared during 6~12 am, and most of the cases of poisoning, trauma, diseases caused by physical and chemical factors, and pediatric diseases appeared during 6-12 pm. Conclusion The top three diseases in pre-hospital care in Lanzhou area are trauma, nervous diseases and cardiovascular diseases. The number of calling 120 patients have two peaks of morning and night. Different diseases have their highest incidence in different time periods.