河南省医用X射线诊断应用频度调查

Survey on frequency of medical X-ray diagnosis in Henan province

目的探讨河南省医用X射线诊断应用分布特点及影响因素,估算全省医用X射线诊断应用频度,为放射诊断的合理应用提供依据。方法采用分层配额抽样的方法选取河南省6个地市不同级别共58家医疗机构为样本医院,调查接受X射线诊断受检者的性别、年龄、检查类型、检查部位等分布信息,并对结果加以分析。结果样本医院中受检者男女比例较为平均,接近1:1;"40~"年龄组比例最高,占60.47%;X射线诊断检查主要为常规X射线摄影和CT检查,分别占52.15%和40.31%;胸部检查在常规X射线摄影和CT检查中应用人次均最高,分别占总检查人次23.84%和13.25%。CT检查集中在二级和三级医院,分别占CT检查人次的21.54%和72.99%;造影检查、乳腺摄影和体外碎石集中在三级医院,分别占同类型检查人次的77.82%、95.01%、100%,一级及其他医院主要进行常规X射线摄影检查,常规摄影检查人次数占一级及其他医院所有检查类型人次数的79.04%。利用多重线性回归模型估算2016年河南省医用X射线诊断频度为826人次/千人口,其中普通X射线诊断检查(包括常规X射线摄影、透视、造影、口腔、乳腺摄影、碎石等放射诊断检查)频度和CT检查频度分别为541人次/千人口和285人次/千人口。结论河南省近年来医疗照射频度水平发展很快,各类放射诊断设备在各级医院分布的不均衡为开展放射卫生工作提出了较大挑战。相关部门应及时调整各级医院放射诊断设备配备、合理利用卫生资源。

Objective To scale the frequencise of medical X-ray diagnosis based on the survey conducted in 58 hospitals to the all hospitals in Henan province,in order to make them available for providing the basis for reasonable application of diagnostic radiology.Methods Stratified sampling method was used to select medical institutions at different levels in 6 cities in the province as sample hospitals.The information of examined patients on sex,age,diagnostic type and exposure category were gathered and the results were analyzed.Results The sex ratio of male and female examined patients was close to 1:1.The largest proportion,60.47%,of examined patients was from the age group of above 40 years old among the three age groups.Medical diagnositc medical X-ray examinations mainly include conventional X-ray photography and CT examination,accounting for 52.15% and 40.31%,respectively.Chest examination contributed the largest propotions,23.84%,of conventional diagnositic X-ray examination and,13.25%,of CT examination respectively.CT examinations were mainly concentrated in the secondary and tertiary hospitals,accounting for 21.54% and 72.99% of the total CT examinations,respectively.Contrast examination,mammography and extracorporeal lithotripsy were concentrated in the tertiary hospitals,accounting for 77.82%,95.01% and 100% of the same type of examinations,respectively.Conventional photographic examinations were mainly conducted in primary hospitals,accounting for 74.56% of all types of examinations in the primary hospitals.By using multiple linear regression model,the diagnostic examination frequency in 2016 was estimated to be 826 examinations per 1 000 population,of which the frequency of dianostic X-ray examination and CT examination were 541 per 1 000 and 285 per 1 000,respectively.Conclusions The frequency of diagnostic radiology in Henan has increased rapidly in recent years.All types of diagnostic radiology equipment are unevenly distributed in hospitals at different levels which posed a challenge for health care.Relevant departments should make efforts to reallocation of diagnostic radiology equipment in such hospitals and make utilization of health resources more reasonable.