2007—2011年单中心截肢临床特点及医疗费用分析

Clinical characteristics and medical cost of amputations in a single center in 2007-2011

目的调查2007—2011年单中心总体截肢情况，分析各不同病因截肢患者的人口学特征、临床特点和住院费用，并分析其与截肢的相关性。方法回顾性调查浙江大学附属第二医院在2007—2011年上半年所有截肢患者，详细记录其人口学特征、病种、既往史、本次入院临床信息、截肢部位、截肢平面、住院时间、住院费用等信息。结果2007—2011年上半年，浙江大学附属第二医院截肢患者共805例，其中男占72．3％；年龄（42．1±18．1）岁。从事农业、工业和运输业等行业者占69．7％。创伤截肢占总体66．1％，其次为肿瘤截肢占15．3％，糖尿病截肢占4．5％，占非创伤性截肢的13．2％。下肢截肢占64．9％，掌指／跖趾关节以上平面截肢占61．7％。截肢患者平均住院时间为20d（14～34d），平均住院费用15000元（8881～31975元）。结论截肢患者仍以青壮年男性为主，创伤是其主要原因，高位截肢、住院时间长、医疗费用高是其主要特点。

Objective To study demographic features, clinical characteristics and in-hospital cost of patients due to different causes in one center in 2007-2011 and discuss their correlation. Methods A retrospective analysis was conducted on all patients who were treated with amputation from 2007 to the first half of 2011 in the Second Affiliated Hospital of Zhejiang University to carefully record their data, such as demographic characteristics, entity, medical history, clinical information, amputation location, amputation level, hospital day and medical cost. Results A total of 805 patients at age of （42.1 ± 18.1 ） years underwent amputation from 2007 to the first half of 2011. Among them, the male patients accounted for 72.3%. The patients engaged in farm, industry and transportation accounted for 69.7%. Traumatic amputation occupied 66. 1%, followed by 15.3% of tumor amputation and diabetic amputation proportioned 4.5%, occupying 13.2% of non-traumatic amputation. Ratios of lower limb amputations and amputations above levels of joints of palmar digitals and toes were 64.9% and 61.7%. Mean hospital day was 20 days （range, 14-34 days） and mean medical cost was 15 000 RMB （range, 8 881-31 975 RMB）. Conclusions Amputation largely occurs in the male adults and mainly results from trauma. High amputation, long hospital stay and high medical cost are the main characteristics.