COVID⁃19流行期间广东省某三甲中医医院发热门诊63455例患者特征分析

Analysis of the Characteristics of 63455 Patients in the Fever Clinic of a Grade⁃A TCM Hospital in Guangdong Province during the COVID⁃19 Epidemic

目的:分析COVID⁃19流行期间,广东省某三甲中医医院发热门诊患者就诊基本特征和疾病谱构成,为提高发热相关疾病救治质量、疾病预防与控制提供参考依据。方法:对广东省某三甲中医医院发热门诊63455例患者就诊病例性别、年龄、就诊时间、分诊级别、主诉和第一诊断进行描述性分析。结果:2020.10.1-2022.9.31,共报告63455例患者,男性占比48.9%,女性占比51.1%;18-40岁(30.5%)和0-6岁(25.1%)人群占比排名前二;急危重患者(Ⅰ级、Ⅱ级、Ⅲ级)占比19.7%,普通患者(Ⅳ级)占比80.3%;成人患者疾病谱分布以呼吸系统疾病(76.7%)和消化系统疾病(21.8%)排名前二,而消化系统疾病以胆道相关性外科疾病(如胆管狭窄、急性胆囊炎/结石)居多,其次为皮肤及皮下组织疾病、神经系统疾病。结论:为更好应对新冠疫情,发热门诊应提级管理、定编定岗;打造一支高素质前哨队伍;扩充抢救空间、配备充足的抢救仪器和药物;合理动态调配人力;充分发挥中医特色优势。不断提升发热门诊传染病筛查和医疗救治质量,实现病情分级诊疗、快速筛查、危重症救治、中西医结合、急诊⁃发热门诊内外联动的全方位一体化诊疗中心。

Objective:To analyze the basic characteristics and disease spectrum composition of fever outpatient pa⁃tients in a third⁃class TCM hospital in Guangdong Province during the COVID⁃19 epidemic,so as to provide reference for improving the quality of treatment,prevention and control of fever related diseases.Methods:A descriptive analysis was conducted on the sex,age,time,triage level,chief complaint and first diagnosis of 63455 patients in the fever out⁃patient department of a third⁃class TCM hospital in Guangdong province.Results:From 2020.10.1 to 2022.9.31,a total of 63455 patients were reported,male accounted for 48.9%,female accounted for 51.1%.The proportion of people aged 18-40(30.5%)and 0-6(25.1%)ranked the top two.The critical patients(gradeⅠ,gradeⅡ,gradeⅢ)accounted for 19.7%,and the common patients(gradeⅣ)accounted for 80.3%;In adult patients,respiratory diseases(76.7%)and digestive diseases(21.8%)were the top two diseases,and digestive diseases were biliary tract related surgical dis⁃eases(such as bile duct stricture,acute cholecystitis/calculi),followed by skin and subcutaneous tissue diseases and nervous system diseases.Conclusion:In order to better respond to the COVID⁃19 epidemic,fever clinics should be up⁃graded to management and assigned posts;Build a team of high⁃quality outposts;Expand rescue space and equip with adequate rescue equipment and medicines;Rational and dynamic allocation of manpower;Give full play to the advantag⁃es of traditional Chinese medicine.Continuously improve the quality of infectious disease screening and medical treat⁃ment in fever clinics,and realize a comprehensive integrated diagnosis and treatment center with graded diagnosis and treatment,rapid screening,critical treatment,integrated traditional Chinese and Western medicine,and emergency⁃fe⁃ver outpatient center.