城乡结合部院外急救病例流行病学特征：上海市宝山区医疗急救中心院外急救18349例分析

Epidemiological features of pre-hospital emergency medical care in urban-rural integration area： analysis of 18 349 cases of Baoshan Emergency Center, Shanghai

目的探讨院外急救病例流行病学特点，全面提升院外急救能力和水平。方法分析上海市城乡结合部的宝山区医疗急救中心2008年1月～9月18349例院外急救病例，对疾病谱的构成、年龄构成、一般急救与危重病构成及病死率进行分析。结果院外急救患者排前5位是骨科疾病、呼吸系统疾病、普通外科疾病、神经系统疾病、心血管疾病，共占院外急救总量的49．6％；65岁以上的老年人占院外急救对象的38．1％。根据院外急救对象病情程度统计，一般急救患者占66．0％，危重患者占31．2％，死亡患者占2．8％，前5位致死疾病是心血管系统（15．3％）、车祸多发伤（11．1％）、恶性肿瘤（10．1％）、呼吸系统疾病（8．0％）、神经系统（6．0％）。结论宝山市120院外急救的主要对象是老年人，在城乡结合部的急救中心，常见的疾病包括骨科及普外科疾病、呼吸系统疾病、心血管系统疾病。

Objective To investigate the epidemiological features of the pre-hospital emergency medical care in the urban-rural integration area. Methods The clinical data of 18 349 cases who underwent pre-hospital emergency medical care of Baoshan Emergency Center, Shanghai, from January 2008-August 2008,were analyzed. Results The 5 most common disease categories among these cases were orthopedic diseases, respiratory system diseases, diseases of general surgery, nervous system diseases, and cardiovascular system diseases, accounting for 49.6% of the whole disease spectrum together. 38.1% of the patients were aged 〉65. According to the severity, the condition of 66,0% of the patients was moderate and that of 31.2% of the patients was serious. The general mortahty was 2.8%. The top five causes of death were cardiovascular system diseases （15.3%）, multiple injury caused by road accident （11.1% ）, malignant tumor （10.1%）, respiratory system diseases （8.0%）, and nervous system diseases （6.0%）. Conclusion The elderly people are the main service object of emergency medical care. In the urban-rural integration area, orthopedic, respiratory, general surgical, neurological, and cardiovascular diseases are the main diseases that need first aid.