乌鲁木齐市2011-2015年院前急救流行病学调查

Epidemiological analysis of pre-hospital first aid in Urumqi in 2011-2015

目的研究乌鲁木齐市（简称乌市）院前急救流行病学特征,为进一步完善院前急救工作,构建合理的院前急救体系提供参考。方法从乌市急救中心指挥系统数据库中调取2011-2015年所有接警数据和患者病历信息,采用ICD-10对疾病编码,应用χ2检验、Fisher确切概率法等对比组间发病率、构成比的差异。结果在5年间的1 270 980次受理呼救中,夏季发病64 639例（26.39%）,时点分布以10：00-12：00最高,发生27 872例（11.4%）;疾病谱排名前5位的是创伤、心脑血管疾病、中毒、神经系统和呼吸系统;在238 661次有效派车中,沙依巴克区最高,共65 377次（26.69%）;院前急救疾病发病率为3 180.93/10万,男女性别比为1.53∶1,男性发病率为3 714.62/10万,显著高于女性发病率2 608.09/10万,RR值为1.42（x2=7 176.071,P〈0.01）;≥35岁年龄组患者最多为180 271例（73.6%）,各年龄段疾病构成（x2=52 316.957,P〈0.01）和发病率（x2=28 052.723,P〈0.01）差异均有统计学意义。结论乌市2011-2015年院前急救疾病呈现出以创伤和心脑血管为主、夏季高发、男性发病率高于女性、≥35岁为高发人群等特点,相关部门应合理配置急救资源、提高医护救治水平、建立完善的院前急救体系。

Objective To describe the epidemiological characteristics of pre-hospital first aid in Urumqi,and to provide references for building a reasonable pre-hospital emergency system. Methods The data and the medical records were retrieved from Urumqi Emergency Medical Center Command System from 2011 to 2015.All the diagnosis was codified by ICD-10.Chi-square test or Fisher′s exact test were used to compare the incidence and proportion among groups. Results Among total 1 270 980 emergency calls in the past 5years,64 639（26.39%）occurred in summer and 11.4% happened from 10：00 AM to 12：00.The top 5diseases were trauma,cardiovascular diseases,poisoning,nerve system diseases and respiratory diseases.The incidence of pre-hospital emergency care was 3 180.93 per 10thousand,which was higher among men with the RRof 1.42（χ2=7 176.071,P〈0.01）.The incidence and disease proportion were significantly different among age groups and most cases（73.6%）were 35 years and over. Conclusions Trauma and cardiovascular diseases are major pre-hospital emergency first aid diseases in 2011-2015 which usually occur in summer.The incidence is higher in men and in those aged 35 years and older.The government should allocate the emergency medical resources appropriately,improve the level of emergency medical treatment and build the complete pre-hospital emergency medical system.