Trend of disease spectrum of hospitalized children in Anhui provincial children's hospital from 2013 to 2017
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摘要:
目的 分析安徽省儿童医院住院儿童疾病谱构成及其变化趋势，为医疗资源合理配置和疾病防治工作提供科学依据。 方法 对安徽省儿童医院2013-2017年268 809例住院儿童疾病构成进行分析，并与该院2003-2007年疾病谱数据进行比较。 结果 与前次统计数据比较，2013-2017年住院儿童人数和涉及病种数均大幅增加。儿童呼吸系统（28.73%vs 26.49%）、消化系统（12.68%vs 10.78%）和神经系统（6.22%vs 3.72%）等常见疾病住院构成比下降；损伤和中毒（2.13%vs 7.4%），传染病和寄生虫（7.15%vs 10.69%）、肿瘤（2.65%vs 4.12%）和血液免疫（1.42%vs 3.19%）等系统疾病住院构成比升高。呼吸系统疾病仍是住院儿童首位系统疾病，占住院儿童总数26.49%，肺炎为单病种首位疾病。2013-2017年住院儿童前5位病种为肺炎、支气管炎、疝气、呼吸道感染、新生儿肺炎。 结论 医院服务人数与服务能力大幅提高；在提高儿童常见发病和多发病诊疗水平的同时，应加强损伤中毒、精神行为疾病和传染病等疾病的防治。 Abstract:Objective To investigate the composition of the disease spectrum of hospitalized children in Anhui Provincial Children's Hospital, so as to provide scientific basis of the strategy to refine pediatric medical resources and health care. Methods Totally 268809 patients from 2013 to 2017 was analyzed and compared with the 2003-2007 data. Results Compared to 2003-2007, the number of hospitalized children and involved diseases increased significantly in 2013-2017. The proportion of common diseases such as respiratory system (28.73% vs 26.49%), digestive system (12.68% vs 10.78%), and nervous system (6.22% vs 3.72%)) significantly decreased; while the proportion of injury and poisoning (2.13% vs 7.4%), infectious diseases, parasites (7.15% vs 10.69%), tumors (2.65% vs 4.12%), and blood immunity (1.42% vs 3.19%) increased. Respiratory diseases remain the first ranking disease in hospitalized children (26.49%), with pneumonia as the first ranking single disease among it. The top 5 hospitalized children in 2013-2017 were pneumonia, bronchitis, hernia, respiratory infections, and neonatal pneumonia. Conclusions The absolute number and capacity of services have been greatly improved in the hospital. While constantly improving the level of diagnosis and treatment of common diseases, we should pay more attention to the injury poisoning, mental and behavioral diseases and infectious diseases in children. -
Key words:
- Children's Hospital /
- Disease spectrum /
- Proportion /
- Trend
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表 1 2003-2007与2013-2017年住院患儿各系统疾病构成比统计学比较及其顺位[n(%)]
Table 1. Proportion and statistics comparison of 20 disease between 2003-2007 and 2013-2017 [n(%)]
系统疾病名称 2003-2007 2013-2017 χ2值 P值 n(%) 顺位 n(%) 顺位 呼吸系统 15 247(28.73) 1 71 218(26.49) 1 112.6 <0.001 起源于围生期的疾病 7 475(14.08) 2 24 329(9.05) 5↓ 1 261.2 <0.001 消化系统 6 732(12.68) 3 28 975(10.78) 2↑ 163.2 <0.001 先天性畸形 5 147(9.70) 4 25 197(9.37) 4 5.5 0.019 其他 4 157(7.83) 5 1 779(0.66) 16↓ 12 590.5 <0.001 某些传染病和寄生虫 3 797(7.15) 6 28 728(10.69) 3↑ 609.0 <0.001 神经系统 3 300(6.22) 7 10 000(3.72) 8↓ 698.0 <0.001 肿瘤 1 408(2.65) 8 11 065(4.12) 7↑ 254.8 <0.001 损伤和中毒 1 129(2.13) 9 19 904(7.40) 6↑ 2 021.1 <0.001 泌尿生殖系统 1 055(1.99) 10 7 870(2.93) 11↓ 145.2 <0.001 肌肉骨髓结缔组织 1 057(1.99) 11 6 009(2.24) 13↓ 12.3 <0.001 血液，造血系统与免疫疾病 755(1.42) 12 8 562(3.19) 9↑ 489.9 <0.001 症状、体征和临床与实验室异常 467(0.88) 13 8 081(3.01) 10↑ 775.2 <0.001 循环系统 463(0.87) 14 3 167(1.18) 15↓ 37.2 <0.001 皮肤和皮下组织 368(0.69) 15 4 612(1.72) 14↑ 304.1 <0.001 内分泌，营养与代谢疾病 235(0.44) 16 981(0.36) 18↓ 7.1 0.008 精神行为障碍 221(0.42) 17 1 501(0.56) 17 16.8 <0.001 眼和附器 49(0.09) 18 6 121(2.28) 12↑ 1 125.2 <0.001 耳和乳突疾病 10(0.02) 19 118(0.04) 20↓ 7.0 0.008 妊娠、分娩和产褥期 1(0.00) 20 592(0.22) 19↑ 114.9 <0.001 
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表 2 住院患儿单病种百分比及其顺位(前10位)
Table 2. Proportion of monopathy in two stage (first 10)
2003-2007年 2013-2017年 病种 n % 病种 n % 肺炎 6 856 12.90 肺炎 39 522 14.70 急性上呼吸道感染 2 508 4.73 支气管炎 16 278 6.06 疝气 2 061 3.88 疝气 12 748 4.74 癫痫 1 271 2.39 呼吸道感染 9 695 3.61 感染性肠道疾病 1 122 2.11 新生儿肺炎 9 415 3.50 出生窒息 865 1.63 骨折 8 352 3.11 新生儿吸入综合症 863 1.63 手足口病 8 108 3.02 阑尾炎 511 0.96 新生儿高胆红素血症 7 664 2.85 哮喘 454 0.86 癫痫 5 936 2.21 骨折 331 0.62 病毒性脑炎 5 108 1.90
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