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目的:基于甘肃省儿童医院连续11年心血管疾病(CVD)住院患儿地域分布及就医方式变化趋势进行分析,为我国西部亚高原欠发达地区儿童CVD早诊早治策略的构建提供依据。方法:获取甘肃省儿童医院2001-2011年CVD住院患儿的完整病历,进行地域分布、就医方式与年份间相关性分析。结果:甘肃省儿童医院2001~2011年连续11年儿童CVD住院患者平均年龄(6.53±6.12)岁,男女比为1.16:1,先天性心脏病是核心病种,占57.51%;11年甘肃各地域儿童CVD住院构成趋势上无变化;62.95%的CVD患儿在经济Ⅲ类、Ⅳ类地区,且快速增长,平均增长速度分别为75.18%和23.38%;11年来CVD患儿就医付费方式无变化,以自费就医为主,占76.32%,健康保险付费仅为5.17%;46.42%的CVD患儿首诊机构是县级医疗机构,且以124.30%的速度增长。结论:基于甘肃省儿童医院的研究提示,在我国西部亚高原欠发达地区建立分级管理、强化县级医疗资源配置的儿童CVD就医网络势在必行;政府为主导的健康保险制度建设是CVD患者早防早治的基本保证,社会慈善力量的救助是欠发达地区CVD患儿诊治的重要补充。
OBJECTIVE: To provide a basis for the strategy of early diagnosis and treatment of CVD in children in underdeveloped areas of western sub-plateau of our country based on the analysis of the geographical distribution of children with cardiovascular diseases (CVD) in children’s hospital of Gansu for 11 consecutive years and the changing trend of medical treatment patterns. Methods: The complete medical record of children hospitalized with CVD in Children’s Hospital of Gansu Province from 2001 to 2011 was obtained, and the geographical distribution, the correlation between the medical methods and the years were analyzed. Results: The average age of CVD hospitalized children in Gansu Children’s Hospital from 2001 to 2011 was 6.53 ± 6.12 years old, the male-female ratio was 1.16: 1. The congenital heart disease was the core disease, accounting for 57.51% There was no change in the trend of CVD hospitalization among children in the region; 62.95% of children with CVD were in category Ⅲ and Ⅳ of economy and grew rapidly, with an average growth rate of 75.18% and 23.38% respectively; there was no change in the way of medical treatment for children with CVD in 11 years , Accounting for 76.32% at their own expenses and only 5.17% for health insurance; 46.42% of the first-visit institutions of CVD were county-level medical institutions and grew by 124.30%. Conclusion: Based on the research results of Children’s Hospital of Gansu Province, it is imperative to set up a CVD management network for children with graded management in the underdeveloped areas of western subtropics in western China and to strengthen the allocation of county-level medical resources. The construction of a government- The basic guarantee of early prevention and early treatment and the relief of social charities are important supplements for diagnosis and treatment of CVD children in underdeveloped areas.