2010~2014年西藏高原部队住院官兵疾病谱分析

Investigation of disease spectrum of in-hospital soldiers from high altitude troops in Tibet between 2010 and 2014

目的 分析西藏部队住院官兵疾病谱变化趋势,为制定高原部队疾病防控策略,合理配置卫生资源提供参考。方法 从成都军区卫生信息中心军队医院信息系统中提取2010年1月1日~2014年12月31日西藏部队住院官兵病案首页数据,共纳入符合要求数据27 593例次,依据出院第一诊断进行疾病分类,采用描述性分析和秩和比法分析疾病构成及顺位变化。结果 30岁以下病例占总病例数的76.74%;消化、损伤和中毒、呼吸、肌肉骨骼、泌尿生殖、循环系统疾病居系统疾病前6位,占81.50%,且5年间一致程度高（P〈0.01）;高原病和急性上呼吸道感染在病种顺位中稳居前2位,其构成比随着年龄增长而上升,40岁以上官兵因高原病而住院的占住院病例15.48%。结论 西藏部队住院官兵疾病谱特征明显,应加强指导基层医疗机构对消化系统、呼吸系统、高原病、训练伤等常见病、多发病的防控,重视自内地返回高原官兵的早期习服和日常活动管理;医院应根据疾病谱特点,针对性提高为兵服务能力。

Objetive To investigate the disease spectrum of in-hospital soldiers from high altitude troops in Tibet and provide a scientific basis for major disease prevention strategies and rational allocation of medical resources at the high altitude areas. Methods 27 593 medical records of in-hospital soldiers from high altitude troops in Tibet between January 1, 2010 and December 31, 2014 were selected by means of the HIS data of the Center of Health Information. According to the first discharge diagnosis, the diseases classification was carried out. Descriptive analysis and rank sum ratio （RSR） method were used to analyze the disease constitution and changes in the sequence, Results The cases under 30 years old accounted for 76.74% of the total number. The top six of the diseases constituent ratio in order were digestive system, injury and poisoning, respiratory system, musculoskeletal and connective tissue, genitourinary and circulatory system, which accounted for 81.50% and had a good degree of harmony during the five years（P 〈 0.01）.The top two major diseases among the inpatients were altitude sickness and acute upper respiratory tract infection which were positively correlated with the ages. Altitude sickness occurred mostly in inpatients over 40, which accounted for 15.48%. Conclusion The disease spectrum of in-hospital soldiers from Tibetan troops has obvious characteristics. Relative departments should strengthen the guidance of preventive and control measures about digestive system, respiratory system, mountain sickness, military training related injury in primary medical units and pay attention to the soldiers＂ early adaptation and daily activities. The hospitals should improve the service ability for soldiers according to the characteristics of disease spectrum.