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热带岛礁某二级医院常见病特征分析

魏宏名 张磊 张忆汝 朱敏 马慧

魏宏名, 张磊, 张忆汝, 朱敏, 马慧. 热带岛礁某二级医院常见病特征分析[J]. 解放军医学院学报, 2023, 44(5): 466-474. doi: 10.3969/j.issn.2095-5227.2023.05.006
引用本文: 魏宏名, 张磊, 张忆汝, 朱敏, 马慧. 热带岛礁某二级医院常见病特征分析[J]. 解放军医学院学报, 2023, 44(5): 466-474. doi: 10.3969/j.issn.2095-5227.2023.05.006
WEI Hongming, ZHANG Lei, ZHANG Yiru, ZHU Min, MA Hui. Characteristics of common diseases in a secondary hospital in a tropical island[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2023, 44(5): 466-474. doi: 10.3969/j.issn.2095-5227.2023.05.006
Citation: WEI Hongming, ZHANG Lei, ZHANG Yiru, ZHU Min, MA Hui. Characteristics of common diseases in a secondary hospital in a tropical island[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2023, 44(5): 466-474. doi: 10.3969/j.issn.2095-5227.2023.05.006

热带岛礁某二级医院常见病特征分析

doi: 10.3969/j.issn.2095-5227.2023.05.006
基金项目: 军队后勤科研计划课题(ALB19J003)
详细信息
    作者简介:

    魏宏名,女,硕士。研究方向:内科学。Email: w_rrcc@163.com

    通讯作者:

    马慧,女,博士,主任医师,解放军总医院护理部主任。Email: mahui-28@163.com

  • 中图分类号: R197.3

Characteristics of common diseases in a secondary hospital in a tropical island

More Information
  • 摘要:   背景  热带岛礁特殊气候与当地常见病的发生相关,热带常见病特征的研究报道较少。  目的  回顾性分析热带岛礁某二级医院门诊就诊情况,探讨与大陆常见疾病谱的差异性,为热带岛礁常见病精准化防治提供参考。  方法  按照国际疾病分类(International Classification of Diseases,ICD)-10标准,统计分析热带岛礁某二级医院2016年1月 - 2019年12月门诊病历中62870例次诊断信息。  结果  就诊人群18 ~ 30岁年龄段占比最高(60.15%),男性(95.83%)占比远高于女性(4.17%)。按人体系统分,排名前5位的是肌肉骨骼系统和结缔组织疾病(19.15%)、呼吸系统疾病(17.57%)、消化系统疾病(15.50%)、皮肤和皮下组织疾病(10.24%)、损伤和中毒(8.13%)。按疾病类型分,排名前5位的是上呼吸道感染(9.81%)、腰痛(5.64%)、意外事故(5.58%)、皮炎(2.96%)、陈旧性肌肉劳损(2.08%)。  结论  热带岛礁常见疾病中上呼吸道感染是主要疾病类型,病原体不明确,存在流感暴发风险,应提高检测能力,予以针对性防控;同时应提高肌肉骨骼系统疾病和皮肤、皮下组织疾病的防治。

     

  • 图  1  占比前10位的一级诊断编码疾病构成比

    M:肌肉骨骼系统和结缔组织病; J:呼吸系统病 K消化系统病; L:皮肤和皮下组织疾病; S:损伤、中毒和外因的某些其他后果; R:症状、体征和临床与实验异常所见,不可归类在他处者; X:暴露于某些有害因素下; Z:影响健康状态和保健机构接触因素; H:眼和附器疾病; B:某些传染病和寄生虫病

    Figure  1.  Composition ratio of the top ten primary diagnosis-coded diseases

    M: Diseases of the musculoskeletal system and connective tissue; J: Diseases of the circulatory system; K: Diseases of the digestive system; L: Diseases of the skin and subcutaneous tissue; S: Injury, poisoning and other consequences of external causes; R: Abnormal symptoms, signs different from clinical and laboratory findings; X: Other external causes of accidental injury; Z: Factors influencing health status and contact with health services; H: Diseases of the eye and adnexa; B: Certain infectious and parasitic diseases

    图  2  占比前10位的二级诊断编码疾病构成比

    J06:多发性和未特指部位的急性上呼吸道感染;M54:背痛;X59:暴露于未特指的因素下;K05:龈炎和牙周疾病;L30:其他皮炎 M62肌肉其他疾患;Z00:无主诉或诊断报告的人接受的一般性检查和调查;B35:皮真菌病;J02:急性咽炎;H10:结膜炎

    Figure  2.  Composition ratio of the top ten secondary diagnosis-coded diseases

    J06: Acute upper respiratory infections of multiple and unspecified sites; M54: Dorsalgia; X59: Exposure to unspecified factor; K05: Gingivitis and periodontal diseases; L30: Other dermatitis; M62: Other disorders of muscle; Z00: General examination and investigation of persons without complaint and reported diagnosis B35: Dermatophytosis; J02: Acute pharyngitis; H10: Conjunctivitis

    图  3  占比前10位的三级诊断编码疾病构成比

    J06.903:上呼吸道感染;M54.503:腰痛;X59.996:意外事故;Z00.001:健康查体;L30.901:皮炎;M62.691:陈旧性肌肉劳损;M62.681:陈旧性腰肌劳损;B35.301:足癣;H10.901:结膜炎;R10.401:腹痛

    Figure  3.  Composition ratio of the top ten tertiary diagnosis-coded diseases

    J06.903: Upper respiratory infections; M54.503: Lumbago; X59.996: Accidents; Z00.001: Health check-up; L30.901: Dermatitis; M62.691: Obsolete muscle strain; M62.681: Old lumbar muscle strain; B35.301: Foot ringworm; H10.901: Conjunctivitis; R10.401: Abdominal pain

    图  4  不同发病月份占比前十位的一级诊断编码疾病构成比

    Figure  4.  The composition ratio of the top ten primary diagnosis-coded diseases in different onset months

    图  5  不同发病月份占比前十位的二级诊断编码疾病构成比

    Figure  5.  The composition ratio of the top ten secondary diagnosis-coded diseases in different onset months

    图  6  不同发病月份占比前十位的三级诊断编码疾病构成比

    Figure  6.  The composition ratio of the top ten tertiary diagnosis-coded diseases in different onset months

    表  1  门诊就诊情况

    Table  1.   Outpatient clinic visits information

     分类例数构成比/%
    临床科室
     急诊外科663413.29
     康复医学科49059.83
     皮肤科47819.58
     骨科46589.33
     呼吸内科42988.61
     急诊内科41278.27
     口腔科37087.43
     创伤外科27575.52
     综合内科26265.26
     消化内科25745.16
    年龄
     <18岁 7261.30
     18 ~ 29岁33511 60.15
     30 ~ 39岁13473 24.18
     40 ~ 50岁657611.80
     >50岁14292.56
    性别
     女23244.17
     男53391 95.83
    地区
     华东839128.55
     华中747025.41
     华北459615.64
     华南427114.53
     东北19326.57
     西南16685.67
     西北10653.62
    发病季节
     夏季风期28512 50.27
     冬季风期28201 49.73
    下载: 导出CSV

    表  2  不同年龄组一级诊断编码疾病比较(例,%)

    Table  2.   Comparison of primary diagnosis-coded diseases in different age groups (n, %)

    诊断编码<18岁(n=726)18 ~ 29岁(n=33511)30 ~ 39岁(n=13473)40 ~ 50岁(n=6576)>50岁(n=1429)χ2P
    M94(12.95)6384(19.05)2725(20.23)941(14.31)237(16.59)126.90<0.0001
    J191(26.31)5750(17.16)2129(15.80)959(14.58)247(17.28)82.69<0.0001
    K70(9.64)4706(14.04)1976(14.67)903(13.73)189(13.23)17.210.0018
    L89(12.26)3650(10.89)1112(8.25)536(8.15)85(5.95)130.55<0.0001
    S38(5.23)2394(7.14)1046(7.76)794(12.07)101(7.07)193.55<0.0001
    R63(8.68)2096(6.25)1018(7.56)542(8.24)110(7.70)54.31<0.0001
    X44(6.06)2025(6.04)718(5.33)443(6.74)36(2.52)47.02<0.0001
    Z42(5.79)1672(4.99)686(5.09)313(4.76)57(3.99)5.000.2876
    H25(3.44)1435(4.28)639(4.74)338(5.14)80(5.60)17.600.0015
    B33(4.55)1611(4.81)615(4.56)250(3.80)42(2.94)21.900.0002
    下载: 导出CSV

    表  3  不同年龄组二级诊断编码疾病比较(例,%)

    Table  3.   Comparison of secondary diagnosis-coded diseases in different age groups (n, %)

    诊断编码<18岁(n=726)18 ~ 29岁(n=33511)30 ~ 39岁(n=13473)40 ~ 50岁(n=6576)>50岁(n=1429)χ2P
    J06121(16.67)3648(10.89)1194(8.86)583(8.87)136(9.52)90.21<0.0001
    M5437(5.10)2088(6.23)974(7.23)268(4.08)77(5.39)78.96<0.0001
    X5944(6.06)2015(6.01)716(5.31)441(6.71)36(2.52)46.31<0.0001
    K0520(2.75)1525(4.55)573(4.25)172(2.62)59(4.13)54.92<0.0001
    L3030(4.13)1442(4.30)553(4.10)268(4.08)52(3.64)2.550.6350
    M6223(3.17)1559(4.65)505(3.75)161(2.45)29(2.0)93.30<0.0001
    Z0033(4.55)1206(3.60)429(3.18)151(2.30)22(1.54)48.05<0.0001
    B3520(2.75)939(2.80)382(2.84)149(2.27)30(2.10)8.700.0690
    J0216(2.20)666(1.99)330(2.45)149(2.27)28(1.96)10.640.0310
    H106(0.83)511(1.52)268(1.99)115(1.75)31(2.17)18.210.0011
    下载: 导出CSV

    表  4  不同年龄组三级诊断编码疾病比较(例,%)

    Table  4.   Comparison of tertiary diagnosis-coded diseases in different age groups (n, %)

    诊断编码<18岁(n=726)18 ~ 29岁(n=33511)30 ~ 39岁(n=13473)40 ~ 50岁(n=6576)>50岁(n=1429)χ2P
    J06.903116(15.98)3444(10.28)1142(8.48)568(8.64)132(9.24)77.31<0.0001
    M54.50334(4.68)1935(5.77)920(6.83)233(3.54)62(4.34)95.24<0.0001
    X59.99640(5.51)1965(5.86)697(5.17)429(6.52)33(2.31)47.66<0.0001
    Z00.00133(4.55)1206(3.60)428(3.18)151(2.30)22(1.54)48.15<0.0001
    L30.90118(2.48)1102(3.29)357(2.65)152(2.31)29(2.03)31.41<0.0001
    M62.69117(2.34)824(2.46)241(1.79)84(1.28)13(0.91)58.53<0.0001
    M62.6816(0.83)716(2.14)257(1.91)69(1.05)15(1.05)45.43<0.0001
    B35.30113(1.79)567(1.69)256(1.90)118(1.79)18(1.26)4.510.3418
    H10.9016(0.83)501(1.50)261(1.94)109(1.66)31(2.17)17.290.0017
    R10.40111(1.52)470(1.40)251(1.86)149(2.27)23(1.61)32.14<0.0001
    下载: 导出CSV
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  • 收稿日期:  2022-10-31
  • 网络出版日期:  2023-05-12
  • 刊出日期:  2023-05-28

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