某医院2018—2020年急诊老年患者疾病谱与10年前同期对照分析

摘要
图/表
参考文献(24)
相关文章 (15)

全文: PDF (569 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的分析解放军总医院第二医学中心（以下简称“我院”）2018—2020年急诊老年患者疾病谱与10年前疾病谱的变化趋势，为改进急救工作、提高急救水平提供参考。方法选取2018年1月—2020年3月，我院急诊科收治的60岁以上老年患者5256例为观察组。年龄60～＜80岁为普通老年患者，≥80岁为高龄老年患者。依据疾病诊断结果进行系统分类，描述目前（观察组）与10年前（对照组，4062例）我院急诊科收治的老年患者疾病构成情况，回顾性比较急诊老年患者疾病谱的变化趋势。结果观察组循环系统疾病构成高于对照组，呼吸、消化系统疾病构成低于对照组，差异有统计学意义（P ＜ 0.05）。尿路感染和房颤疾病构成高于对照组，上呼吸道感染、急性胃肠炎构成低于对照组，差异有统计学意义（P ＜ 0.05）。观察组除纳入疾病外的其他疾病高于对照组，差异有统计学意义（P ＜ 0.05）。观察组普通老年患者泌尿、其他系统疾病构成高于对照组，呼吸、消化系统疾病构成低于对照组，差异有统计学意义（P ＜ 0.05）。观察组高龄老年患者循环系统疾病构成高于对照组，消化、其他系统疾病构成低于对照组，差异有统计学意义（P ＜ 0.05）。观察组普通老年患者冠心病构成位居首位，且高于对照组，短暂脑缺血发作、上呼吸道感染、急性胃肠炎构成低于对照组，差异有统计学意义（P ＜ 0.05）。观察组高龄老年患者尿路感染与房颤构成明显高于对照组，差异有统计学意义（P ＜ 0.05）。结论与10年前比较，急诊老年患者慢性病呈上升趋势，循环系统疾病成为最常见的疾病。急诊工作者根据疾病谱的特点优化就诊流程，加强循环、呼吸、泌尿、外伤等各专科急症的培训，对老年患者做好健康宣教并提供针对性预防措施。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘俊1 孙莹1 杨雪1 米卫东2

关键词 ：急诊, 老年患者, 疾病谱, 对照分析

Abstract：Objective To analyze the change trend of the disease spectrum of emergency elderly patients in the Second Medical Center of the People′s Liberation Army General Hospital (“our hospital” for short) from 2018 to 2020 and the disease spectrum ten years ago, and to provide references for improving first-aid work and to improve first-aid level. Methods A total of 5256 patients over 60 years old admitted to Department of Emergency in our hospital from January 2018 to March 2020 were selected as the observation group. Patients aged 60 to less than 80 years old were ordinary elderly patients, and older patients aged ≥80 years old. According to the diagnosis results of the disease, elderly patients admitted to the Department of Emergency in our hospital at present (observation group) and ten years ago (control group, 4062 cases) were classified and described, and the trend of disease spectrum of emergency elderly patients were compared retrospectively. Results The composition of circulatory diseases in the observation group was higher than that in the control group, while the composition of diseases in the respiratory and digestive systems was lower than that in the control group, and the differences were statistically significant (P ＜ 0.05). The composition of urinary tract infection and atrial fibrillation were higher than those of the control group, while the composition of upper respiratory tract infection and acute gastroenteritis were lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). Except for the included diseases, the other diseases of observation group was higher than that of the control group, and the difference was statistically significant (P ＜ 0.05). The urinary and other system diseases in the observation group were higher than those in the control group, while the respiratory and digestive system diseases were lower than in the control group, and the differences were statistically significant (P ＜ 0.05). The composition of circulatory diseases in the observation group was higher than that in the control group, while the composition of digestive and other system diseases were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). The composition of coronary heart disease in the observation group ranked first and was higher than that of the control group. The composition of transient ischemic attack, upper respiratory tract infection, and acute gastroenteritis were lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). The composition of urinary tract infection and atrial fibrillation in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P ＜ 0.05). Conclusion Compared with ten years ago, chronic diseases of elderly patients in emergency department are on the rise, and circulatory system diseases have become the most common diseases. According to the characteristics of the disease spectrum, emergency department workers optimize the treatment process, strengthen the training of circulatory, respiratory, urinary, trauma and other specialized emergency diseases, and provide health education and targeted preventive measures for elderly patients.

Key words： Emergency Elderly patients Disease spectrum Comparison analysis

基金资助:国家老年疾病临床医学研究中心开放课题（NCRCG-PLAGH-2017009）；
国家重点研发计划项目（2018 YFC2001900）。

通讯作者: 杨雪（1972-），女，硕士，解放军总医院第二医学中心门诊部主任，副主任医师，主要从事老年健康管理及老年心血管病的诊治。

引用本文:

刘俊1 孙莹1 杨雪1 米卫东2. 某医院2018—2020年急诊老年患者疾病谱与10年前同期对照分析[J]. 中国医药导报, 2020, 17(30): 59-63.
LIU Jun1 SUN Ying1 YANG Xue1 MI Weidong2. Comparative analysis of the disease spectrum of elderly emergency patients in a hospital from 2018 to 2020 compared with the same period ten years ago. 中国医药导报, 2020, 17(30): 59-63.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I30/59

[1] 郭伟，周明.急诊医学与叙事医学的交集[J].医学与哲学，2018，39（7B）：17-19.
[2] 阮韦淑怡，陆远强，何文炯.构建老年危重症患者救治过程中和谐医患关系的管理思路探讨[J].中华危重症医学杂志，2017，10（2）：73-75.
[3] 陈宏毅，袁静.情景模拟教学对住院医师规范化急救技能培训效果评价[J].基础医学与临床，2019，39（11）：1662-1665.
[4] 刘红梅，王明旭，孔德玲，等.成组综合急救模拟演练应用在护士急救技能培训中的效果评价[J].中华现代护理杂志，2016，22（5）：608-612.
[5] 程新春，刘鹏，苗海军，等.2005—2017老年住院患者疾病谱的回顾性分析[J].新疆医学，2018，48（12）：1268-1270.
[6] 曹阳，高冉冉，郭飞.新疆某三甲医院急诊留观患者流行病分析[J].解放军医院管理杂志，2019，26（10）：950-953.
[7] 罗东，程涛，董明明，等.不同来诊方式急诊患者就诊规律及特点分析[J].中华全科医师杂志，2019，9：847-850.
[8] 黄隽敏，庄须翠，王真.急诊留观患者的流行病学现状调查[J].华西医学，2019，11：1239-1243.
[9] 田月强，金岚，刘俊，等.4062例老年急诊患者疾病谱分析及护理启示[J].护理学报，2012，19（6B）：37-40.
[10] 王丽萍，谢栓栓，王昌惠.PM2.5对呼吸系统疾病的影响及其相关机制[J].临床肺科杂志，2019，24（1）：148-151.
[11] 张春燕.老年住院患者肺部感染死亡危险因素分析[J].中国病案，2018，19（11）：35-37.
[12] 范利.感染诱发的老年多器官功能障碍综合征诊治中国专家共识导读[J].中华老年多器官疾病杂志，2018， 17（1）：1-2.
[13] Ryan PS，Gormley GJ，Hart ND. Preparation for practice：a novel role for general practice in pre-foundation assistantships [J]. Educ Prim Care，2017，28（4）：210-215.
[14] 杨军，靳微，何新华，等.基层医护人员抢救技术培训结果的分析报告[J].中国急救医学，2019，39（9）：873-878.
[15] 赵玲，肖红艳，马红英.急性心肌梗死院前急救护理及转运改良流程的效果观察[J].实用临床护理学电子杂志，2018，3（24）：60-63.
[16] 李晴晴，洪华山.早发血管衰老的临床研究进展[J].中华老年心血管病杂志，2019，21（6）：654-657.
[17] 刘文红，马丽娟.优化急诊护理流程在急性心肌梗死患者抢救中的效果研究[J].中国急救复苏与灾害医学杂志，2018，13（1）：55-58.
[18] 崔庆宏，徐军，朱华栋.北京协和医院急诊从业人员心肺复苏实施情况的研究[J].临床急诊杂志，2016，17：535-537.
[19] 杜鹏辉.急诊抢救室患者流行病学调查及分析[J].基层医学论坛，2017，21（32）：4445-4447.
[20] 张海华，王素文，管丽娜.急诊绿色通道开通对急性缺血性脑卒中患者静脉溶栓效果的影响[J].山东医药，2018，58（21）：77-79.
[21] 曾健平，李邵杰，袁光雄，等.医院脑卒中绿色通道管理实践[J].中华医院管理杂志，2018，34（6）：487-489.
[22] 张春妍，尹文超，杨丽华．急诊科护士团队合作度现状及影响因素分析[J].护理学杂志，2016，31（20）：66-69.
[23] 冀佳佳，郝艳华.2013—2016年黑龙江省某三甲综合医院急诊疾病谱分析[J].哈尔滨医科大学学报，2017， 15（6）：562-567.
[24] 蒋祎，刘亚兰，邓境，等.中国急救医疗服务需要和利用及资源分布的地区公平性研究[J].中国全科医学，2017， 20（35）：4417-4422.