包头市41387例院外急救患者流行病学分析与对策

Analysis of Baotou 41,387 pre-hospital emergency cases on the epidemiological characteristics and the countermeasures

目的了解包头市院外急救疾病谱并予以对策；方法调取本市120指挥中心2008年～2011年，受理急救患者数据，进行统计分析。结果受理患者总数41837例，男性29072例，占总数70．25％；女性12315例，占总数29．76％，男女比例2．36：1。受理疾病谱：创伤类占30．47％（12611人）循环系统疾病占14．04％（5809人）神经系统疾病13．07％（5410人）呼吸系统疾病占6．54％（2707人）消化系统疾病占3．04％（1260人）；物理化学伤类疾病占15．96％（6607人）主要以醉酒占6．91％、药物中毒占2．17％、煤气中毒占1．17％为主，其他均不足0．1％；院外急救昏迷者占2．75％（1139人）危重症者占3．51％（1470人）死亡6．34％（2627人）死亡者男性1679人、女性948人、男女比例1．77：1；全天出诊20：00。23：00最多，占58．67％，全年平均3、10月患者最多，6、7月次之，2、4、5月份最少。结论创伤发生比例较高，14～45岁居多明显于其他年龄组；循环、神经、呼吸、消化系统疾病均56岁以上受理者居多；除药物中毒、孕产妇及小于14岁以下者女性多于男性外，其他受理者均男性多于女性；物理化学伤类发病与地区生活习惯、气候条件及工作环境有关。此外，本市院外急救死亡率偏高。对策：加强急诊医疗的连续性和院内治疗的协调性；缩短救治半径，增加急救分站；提供应急预警与完善急救预案，加强急诊建设；加强社区对老年病慢性病与季节性多发病的宣教工作；加强社会监管，安全生产、交通安全及法制意识。

Objective To fully understand its own pre-hospital decease spectrum in order to create an effective countermeasure. Methods Data of 120 pre-hospital medical services provided between 2008 arid 2011 was compelled and statistically analyzed. Results In a total of 41,837 patients were 29,072 male （70.25%） and 12,315 female （29.76%）, with a ratio of 2.36：1. On the decease spectrum were trauma, there were 12,611 patients with trauma （30.47%）, 5,809 patients with circulation system disease （14.04%）, 5,410 patients with disease of the nervous system （13.07%）, 2,707 patients with respiratory system diseases （6.54%）, 1,260 patients with digestive system diseases （3.04%）, 6,607 patients with physical/chemical injury （15.96%） of which was mainly the drunk （6.91%）, medicine poisoning （2.17%）, gas poisoning （1.17%）, with the rest of less than 0.1%; 1,139 coma patients （2.75%）, 1,470 patients with critical condition （3.51%）, 2,627 death case （6.34%） including 1,679 males and 948 females with a ratio of 1.77：1. Most dispatches happened in between 8pm and 1 lpm （58.67%）; the peak months were March and October followed by June and July, and lesser amount of patients were found in February, April and May. Conclusion Trauma case was rated the highest with age spectrum of 14 to 45 year-old than any other age spectrum; decease of circulation, nerve, respiratory, digestive systems occurred in patients who were on and above 56 year-old in general; Other than drug poisoning, maternal and those younger than 14 years old in which female patients took the majority, male patients took the majority in the rest cases. Physical/ chemical injuries occurred were relevant to the environment that patients worked and lived. In addition, a higher mortality was reflected on the pre-hospital phrase. Countermeasures may include strengthening coordination of a continuing pre-hospital emergency treatment with the follow-up in-hospital treatment, shortening emergency radius, adding more first-aid stations, providing early-warning and perfecting the emergency plans, as well as strengthening infrastructures of emergency medical services. Simuhaneously, popularize education of chronic and seasonal frequently-occurring diseases in the communities, and perfecting social supervision, safety in production, transportation Safety and legal awareness.