老年与中青年手术患者疾病谱特点的比较分析

Comparative Analysis of Disease Spectrum Characteristics between the Elderly and the Youth and Middle-aged Surgical Patients

目的通过比较老年手术患者与中青年手术患者疾病分布特点,探讨老年手术患者人群分布和疾病谱顺位特点,为有针对性地提升医疗技术、提高老年人的生活质量提供借鉴。方法回顾性选取2010—2014年唐山市工人医院出院的符合纳入标准的手术患者为研究对象。按照年龄将其分为中青年患者(15~59岁)和老年患者(≥60岁)。收集患者性别、年龄、出院日期、主要诊断疾病等,统计逐年出院人次。结果 2010—2014年共有手术患者46 507人次,其中老年患者13 909人次,中青年患者32 598人次。老年患者逐年出院人次呈上升趋势,中青年患者逐年出院人次呈下降趋势(P<0.05)。老年患者中男性比例大于中青年患者(P<0.05)。老年患者出院人次随年龄的增长而减少(P<0.05)。老年患者主要为60~、65~、70~岁患者,其累计构成比为80.88%。中青年患者出院人次随年龄的增长而增多(P<0.05)。中青年患者主要为35~、40~、45~、50~、55~59岁患者,其累计构成比为76.06%。统计分析和谐系数(W_R)=0.870 6,进一步检验显示,χ~2=19.154,ν=11,P>0.05,尚不能认为老年患者与中青年患者疾病谱顺位存在一致性。老年患者前3位疾病为肿瘤(30.02%)、泌尿生殖系统疾病(19.94%)、消化系统疾病(17.36%);而中青年患者前3位疾病为肿瘤(34.80%),泌尿生殖系统疾病(15.36%),损伤、中毒和外因的某些其他后果(15.18%);老年患者眼及其附器疾病疾病谱顺位高出中青年患者6个位次,而影响健康状态和与保健机构接触的因素低于中青年患者5个位次。结论不同年龄人群疾病分布特点不同,老年手术患者眼及其附器疾病疾病谱顺位高于中青年患者,要根据不同年龄人群特征有针对性地制定三级预防策略,提高患者生存质量。

Objective By comparing the characteristics of disease distribution in elderly patients with youth and middle-aged patients,to investigate the population distribution and disease spectrum characteristics of elderly surgical patients,and to provide reference for targeted promotion of medical technology and improvement of the life quality of the elderly. Methods Surgical patients discharged from Tangshan Gongren Hospital and met the inclusive criteria were retrospective selected as study subjects from 2010 to 2014. All subjects were divided into young and middle-aged patients（ 15-59 years old） and elderly patients（ ≥60 years old）. The patients＇ sex,age,date of discharge,principal diagnostic diseases and et al. were collected,and the discharge number of patients was counted each year. Results There were 46 507 surgical cases from 2010 to 2014,including 13 909 elderly cases,and 32 598 young and middle-aged cases. The annual discharge number of elderly cases was on the rise,but it was declining in young and middle-aged cases（ P〈0.05）. The proportion of males in elderly patients was higher than that in young and middle-aged patients（ P〈0.05）. The discharge number of elderly patients decreased with age（ P〈0.05）. The elderly patients were mainly 60-,65- and 70-year-old patients,and the cumulative constituent ratio was 80. 88%. The discharge number of young and middle-aged patients increased with age（ P〈0.05）. The proportion of young and middle-aged patients was mainly 35-,40-,45-,50-and 55-59 years old patients,and the cumulative constituent ratio was 76. 06%. The statistical analysis showed that W_R= 0. 870 6,further test showed that there was still no consistency of sequence of disease spectrum between the elderly patients and the young and middle-aged patients（ χ~2= 19. 154,ν = 11,P〈0.05）. Tumors（ 30. 02%）,urinary tract disease（ 19. 94%） and digestive disease（ 17. 36%） ranked top three in the elderly patients,while in young and middle-aged patients, the top three diseases were tumors（ 34. 80%）, urinary tract disease（ 15. 36%）,injury,poisoning and other consequences of external causes（ 15. 18%）. The disease spectrum of ocular and adnexal diseases in the elderly patients was 6 ranks higher than that of the young and middle-aged patients,while the factors that affect health status and exposure to health care institutions were 5 ranks lower than those of young and middle-aged patients. Conclusion The disease distribution characteristics of different age groups is different. The disease spectrum of ocular and adnexal diseases in the elderly patients is higher than that of the young and middle-aged patients. According to the characteristics of different age groups, tertiary prevention strategy should be targeted to develop in order to improve patients＇ quality of life.