2010~2014年西藏高原部队住院官兵疾病谱分析

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目的分析西藏部队住院官兵疾病谱变化趋势,为制定高原部队疾病防控策略,合理配置卫生资源提供参考。方法从成都军区卫生信息中心军队医院信息系统中提取2010年1月1日~2014年12月31日西藏部队住院官兵病案首页数据,共纳入符合要求数据27 593例次,依据出院第一诊断进行疾病分类,采用描述性分析和秩和比法分析疾病构成及顺位变化。结果 30岁以下病例占总病例数的76.74%;消化、损伤和中毒、呼吸、肌肉骨骼、泌尿生殖、循环系统疾病居系统疾病前6位,占81.50%,且5年间一致程度高(P<0.01);高原病和急性上呼吸道感染在病种顺位中稳居前2位,其构成比随着年龄增长而上升,40岁以上官兵因高原病而住院的占住院病例15.48%。结论西藏部队住院官兵疾病谱特征明显,应加强指导基层医疗机构对消化系统、呼吸系统、高原病、训练伤等常见病、多发病的防控,重视自内地返回高原官兵的早期习服和日常活动管理;医院应根据疾病谱特点,针对性提高为兵服务能力。 Objective To analyze the changing trend of disease spectrum of officers and soldiers in hospital in Tibet and provide reference for the strategy of prevention and control of altitude sickness diseases and rational allocation of health resources. Methods From January 1, 2010 to December 31, 2014, the data of the first case of in-patient officers and soldiers of in-service troops in Tibet were extracted from the information system of the Military Hospital of Chengdu Military Region Health Information Center. A total of 27 593 cases of compliance data were included and based on the first diagnosis of discharge Disease classification, using descriptive analysis and rank sum ratio analysis of disease composition and changes in position. Results The number of cases under the age of 30 accounted for 76.74% of the total number of cases; digestive, traumatic and poisoning, respiratory, musculoskeletal, genitourinary and circulatory diseases ranked the top 6, accounting for 81.50% of the total, and the consistency was high in 5 years (P < 0.01). Altitude sickness and acute upper respiratory tract infection were the top two in disease rankings, and their composition ratios increased with age. The number of hospitalized patients aged 40 and over who suffered from altitude sickness was 15.48%. Conclusion The disease spectrum of officers and soldiers in Tibet is obvious. It is necessary to strengthen the guidance of prevention and control of common diseases and frequently-occurring diseases such as digestive system, respiratory system, altitude sickness, and training injuries in primary health care institutions. Emphasis should be placed on early service and routine Activity management; hospitals should be based on the characteristics of the disease spectrum, targeted to improve service capabilities.
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