综合医院急诊危重患者流行病学分析

Epidemiological analysis on critical care patients in the emergency department of a comprehensive hospital

目的研究急诊科抢救区危重患者的流行病学特点。方法对2011年急诊科抢救区2987例危重患者的年龄、性别、入科及转归时间分布、疾病谱和病死率等进行回顾性分析。结果循环系统、神经系统、呼吸系统疾病是急诊科的前3位危重病；男性多于女性；60～79岁老年组抢救人数最多；病死率由高到低前3位疾病是院前猝死、血液系统疾病和呼吸系统疾病；急诊抢救患者全年出现2个就诊高峰，分别为4月及12月，全天就诊高峰在16：00～20：00。结论危重患者的抢救工作是急诊工作的重中之重，应及时解除危及生命的紧急情况并尽快分流；抢救对象主要为老年心脑血管及呼吸系统疾病；应根据急诊抢救患者的分布特点合理安排人员及物资；建立病死率较高的几种急性单病种的绿色通道，建立院内合作团队，提高抢救成功率；做好相关的健康宣教工作，普及高危人群的急救知识。

Objective To investigate the epidemiologieal features of critical patients in our emergency rescue area. Methods The ages, genders, time distribution of entering and turning out, disease scores and mortality rates of 2987 critical care patients rescued in emergency department of our hospital in 2011 were retrospectively analyzed. Results Circulatory, neurological diseases and respiratory diseases were the top three critical diseases in the emergency department. More male cases were received than female cases. Senior citizens aged from 60 to 79 were the largest group needing rescue. The diseases contributed to the top three mortality rates were sudden death out of hospital, hematological diseases and respiratory diseases. Peak time of the rescuing were December and April of the year and 16 ： 00 to 20 ： 00 of the day. Conclusions Resuing critical care patients is the emphasis of the emergency department. Promptly solving fatal problems and sending patients to relevant units as soon as possible is the necessary. Given the main targets are elderly patients with cardiac or cerebrovascular diseases as well as respiratory diseases, emergency staff and resources should be arranged and assigned properly according to the distribution features of the critical patients. Rescue green channel of several fatal diseases could be built to establish cooperative teams and improve the success rate of rescuing. Health education should also be strengthened to promote the emergency treatment knowledge for the high risk population.