北京地区某医院2014~2018年肠道门诊流行病学分析

Epidemiological analysis of intestinal outpatient service in a hospital in Beijing from 2014 to 2018

目的对肠道门诊连续五年的临床病例进行整理分析及讨论,以掌握其分布规律和流行趋势,为制定和完善传染病防治策略和措施提供科学依据。方法以2014年1月1日至2018年10月31日连续五年首都医科大学附属北京友谊医院肠道门诊就诊共10 808例病例为研究分析对象,对就诊人群年龄分布、就诊月份分布、发病病症、实验结果和临床诊断进行分析。结果①五年来病例统计年龄分布在21~40岁最多,占比41.3%;其次为51~70岁,占比33.1%。②每年6~8月为急性腹泻高发期,就诊人数与气温高低呈正比。③五年腹痛发生率差异具有统计学意义(P<0.01),但腹痛发生的部位差异无统计学意义(P>0.05)。对于腹痛部位,五年来统计数据表明,脐周发生率最高,其次为上腹部,再次为下腹部。患者伴有里急后重症状的人数显著低于无里急后重症状者,差异具有统计学意义(P<0.01)。④五年来,不同性状大便比率差异具有统计学意义(P<0.01),占比最多的前3位分别为糊状或稀样便、水样便和黏液便。动力阴性细菌比率显著高于动力阳性细菌(P<0.01),动力阳性细菌检出率近3年呈下降趋势。志贺菌属检出量逐年下降,五年比较差异具有统计学意义(P<0.05),沙门菌属检出量差异无统计学意义(P>0.05)。近五年内共检出霍乱弧菌2例。⑤近五年腹泻待查为肠道门诊临床诊断的首位,占比60%左右;其次为感染性腹泻,占比约30%左右。菌痢诊断近3年呈下降趋势。结论该医院所在地区5年来肠道传染病的基本特征为:患者以青壮年居多、夏季高温时多发,疾病发生时不同年份腹痛发生概率差异大、脐周发生疼痛的概率最高、大便性状以糊状或稀样便等为主。

Objective To analyze and discuss the clinical cases of the intestinal clinic of Beijing Friendship Hospital,Capital Medical University for five consecutive years from 2014 to 2018,aiming at grasping its distribution rules and epidemic trends,and providing scientific basis for improving infectious disease prevention strategies in the future.Methods 10 808 cases of the intestinal outpatient department,Beijing Friendship Hospital,Capital Medical University for five consecutive years from April 1,2014 to October 31,2018 were collected.The age distribution,month distribution,disease,experimental results and clinical diagnosis were analyzed.Results ①In the past five years,the largest age distribution of patients is among 21-40 years old,accounting for 41.3% and then 51~70 years old,accounting for 33.1% .②From June to August each year,the incidence of acute diarrhea was high,and the number of patients was directly correlated to the temperature.③There was significant difference in the incidence of abdominal pain over 5 years(P<0.01)but the location of abdominal pain was not statistically significant(P >0.05).For the location of abdominal pain,the incidence of periumbilical area pain was the highest,followed by the upper abdomen and then the lower abdomen.The number of patients with tenesmus was significantly lower than that of patients without tenesmus(P<0.01).④In the past five years,there was a significant difference in the proportion of stools with different traits(P<0.01),and the top three were: paste or thin,watery and mucus.The proportion of dynamic negative bacteria was significantly higher than that of dynamic positive bacteria(P<0.01),and the detection rate of dynamic positive bacteria showed a downward trend in the past three years.The detection rate of Shigella decreased year by year and the difference was statistically significant in five years(P<0.05),but there was no statistical difference in the detection rate of Salmonella genus(P>0.05).In addition,two cases of Vibrio cholerae were detected in the past five years.⑤In the past five years,diarrhea with uncertainty reasons was the first clinical diagnosis of intestinal outpatients,accounting for about 60%,followed by infectious diarrhea,accounting for about 30%.The diagnosis of bacillary dysentery showed a downward trend in the past three years.Conclusion In the past five years,the basic characteristics of intestinal infectious diseases in the area where the hospital is located are as follows: patients are mostly young,and cases are more frequent in summer with high temperatures.The incidence of abdominal pain varies greatly in different years,mostly located in the periumbilical area and the main characteristics of stool are paste or thin stool.