某三甲医院2017—2022年住院患儿疾病谱变化

Changes in the Disease Spectrum of Hospitalized Children in a Tertiary General Hospital from 2017 to 2022

目的:探索新型冠状病毒感染(COVID-19)发生前后住院患儿疾病谱变化。方法:收集2017年1月—2019年12月某三甲医院小儿内科及新生儿科(疫情前组)和2020年1月—2022年12月(疫情后组)所有住院患儿首页信息,依据国际疾病分类第十次修订本(ICD-10)进行编码,比较疫情前后患儿疾病谱变化情况。结果:疫情后,收治患儿数量较疫情前同比下降47.36%。疫情后组呼吸系统疾病、某些传染病和寄生虫病所占比例较疫情前组下降,差异有统计学意义(χ^(2)=60.02、43.97,P<0.001)。疫情后,内分泌、营养和代谢疾病、损伤、中毒和外因的某些其他后果、肌肉骨骼和结缔组织疾病、精神和行为障碍等占比均呈上升趋势,上升幅度为0.2%~1.7%,差异有统计学意义(t=118.38、39.41、39.48、8.05,P<0.001),其中内分泌、营养和代谢疾病顺位变化最大,由第13位升至第7位。按照不同年龄分期,学龄期患儿内分泌、营养和代谢疾病占比呈上升趋势,上升幅度达6.39%,位列第2位;青春期患儿中损伤、中毒和外因的某些其他后果的占比明显提高,上升幅度达6.48%。结论:COVID-19疫情后住院患儿数量明显减少,疾病谱发生了显著变化。

Objective:To explore the changes of disease spectrum of hospitalized children before and after COVID-19 epidemic.Methods:Collecting the homepage information of all hospitalized children in Department of Pediatrics and Neonatology of a tertiary hospital from January 2017 to December 2019(pre epidemic group)and from January 2020 to December 2022(post epidemic group),and compare the changes in the disease spectrum of children before and after the epidemic based on the International Classification of Diseases(ICD-10)code.Results:The number of children admitted after the epidemic decreased by 47.36%compared to the same period before the epidemic.The proportion of respiratory disease,some infectious diseases and parasitic disease in the post epidemic group was lower than the pre epidemic group(χ^(2)=60.02,43.97;P<0.001).After epidemic,the proportion of endocrine,nutritional and metabolic disorder,injuries,poisoning and some other consequences of external causes,musculoskeletal and connective tissue disease,mental and behavioral disorders showed an upward trend of 0.2%~1.7%(t=118.38,39.41,39.48,8.05;P<0.001).Endocrine,nutritional and metabolic disorder have the largest change in sequence from 13th to 7th.According to different age stages,the proportion of endocrine,nutritional and metabolic disorder in school-age children has increased by 6.39%,ranking the second.The proportion of injuries,poisoning and other external consequences among adolescent children has significantly increased,with an increase of 6.48%.Conclusion:After COVID-19 epidemic,the number of hospitalized children has significantly decreased,and the disease spectrum has undergone significant changes.