兰州地区危重病例的流行病学研究

Epidemiological study of critical patients in Lanzhou area

目的：研究急诊科危重患者的基本流行病学资料，提高急诊救治效率，制定危重病种的防治策略。方法：选择自2009—09—2010—08间就诊于我院急诊科的符合纳入标准的3436例危重病患者，分析其性别、年龄、就诊时间、疾病谱的分布和构成特点，进行流行病学描述性研究。结果：老年组人数最多（47．06％）；男性患者多于女性；急诊危重病种的前三位为心血管疾病、神经系统疾病、消化系统疾病；病死以院前死亡人数最多（37．14％）；就诊时间分布的特点为全年的7月至8月和12月至次年2月两个高峰，全天就诊高峰时段为17：00～24：oO。结论：培养一专多能的急诊科医师；按就诊时间分布，合理分配医疗资源，加强三级预防，尤其是病因预防；老年人应重点防治基础疾病，中年人应注意早期干预相关危险因素，青少年注意预防意外伤害的发生；同时需加强急救理念和急救知识的宣传与普及，减少院前死亡人数。

Objective：We aim to improve the efficiency of emergency management of critically ill patients and try to establish the prevention and treatment strategies for acute and severe diseases, by reviewing and researching the cases of severe patients adopted by our emergency department. Method ： Among the patients who had been trea ted in Emergency Department from September, 2009 to August, 2010,3 436 cases were enrolled according to the inelusive criteria. A /etrospeetive descriptive study and epidemiological methods were applied to analyze gender,age, visiting time,the distribution and composition of disease spectrum and some other factors. Result ： Most cases were elderly individuals （47.06%）, and male patients were more than female ones （54.74% vs 45.26 % ）. The results atso indicated that the three most common critical diseases were cardiovascular diseases, nervous sYstem diseases and gastrointestinal diseases respectively;meanwhile, Pre-hospital death accounted the largest proportion of mortal ity （37.14%）. The distribution of visiting time peaked during July to August and December to next February an nually. And the daily peak visiting time was 17：00 - 24： 00. Conclusion：Multi-skilled emergency doctors who know the general idea of critically ill cases are badly needed in order to improve the level of diagnosis and treatment. And reasonable distribution of medical resources according to the visiting time peak is essential. Tertiary prevention, es- pecially primary prevention should be strengthened. The keypoint for prevention in geriatric patients was control- ling and treating their underlying diseases ; When it comes to the middle aged, early interventions on certain risk factors should be taken very seriohsly;and the prevention of unintentional injuries among adolescents needs great emphasis. Meanwhile,in order to reduce pre-hospital mortality,the idea and knowledge of the first aid should be advocated and prompted to the public.