不同时期神经内科门诊患者的特点分析

Analysis of the Characteristics of Outpatients in Neurological Department in Dif erent Periods

目的分析不同时期综合医院神经内科门诊患者的特点,旨在为神经内科门诊医疗服务决策提供参考。方法通过医院门诊病案管理系统,分别纳入1994年8月-9月(1994年组)和2012年8月-9月(2012年组)在某综合医院神经内科门诊就诊的患者,其中1994年为连续就诊的患者1 000例;2012年为去除重复就诊患者,排除待诊(包括头昏、头晕)、误分诊的重型精神疾病(如精神分裂症)或内科疾病患者后,获得的具有可比性的门诊就诊数据,共18 995例。比较1994年组和2012年组门诊就诊患者的人口学及病种分布指标,并进行统计学分析。结果 2012年组较1994年组神经内科门诊患者女性比例增高,青年患者所占比例减少,而老年组的患者所占比例增多(P<0.05)。其中神经症、脑血管病、内科疾病伴发神经损害、周围神经疾病、颅脑外伤后综合征、颅内占位性病变构成比例降低,而头痛、癫痫、锥体外系疾病(如帕金森病)增加(P<0.01),肌肉疾病和神经性肌萎缩、脊髓病、脑萎缩或痴呆类疾病无明显差异。结论 2012年组神经内科门诊患者特点较1994年组有显著变化,这些差异为门诊资源优化配置及防治政策的制定提供了一定的证据。

Objective To analyze the characteristics of outpatients in Neurological Department in different periods and to provide guidance on medical decision-making for Neurological Department. Methods Outpatients treated between August and September 1994 （group 1994） and between August and September 2012 （group 2012） in the Department of Neurology of a general hospital were included in our study. Group 1994 had 1 000 consecutive patients; while group 2012 had 18 995 patients excluding those repeat visitors, patients waiting to be treated （including dizziness）, patients misdiagnosed to have severe mental diseases （such as schizophrenia）, and patients with physical diseases. Then we compared the demographic and disease distribution of patients in the two groups, and performed statistical analysis. Results Compared with the year 1994, the year 2012 had more female, less young and more elderly patients （P 〈 0.05）. The constituent ratio of neurosis, cerebrovascular disease, internal medicine diseases with nerve damage, peripheral nerve disease, brain post-traumatic syndrome, intracranial space-occupying lesions reduced significantly while headache, epilepsy, extrapyramidal disease （such as Parkinson＇s disease） increased significantly （P 〈 0.01） with no obvious change of constituent ratio of muscle disease, neuropathic muscular dystrophy, spinal cord, brain atrophy and dementia diseases. Conclusions There are significant changes in characteristics of neurology clinical patients between 1994 and 2012. Revelation of these differences can provide evidence for the optimization of outpatient resources allocation and theprevention policy.