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目的调查四川省双流县永安中心卫生院2009年度住院疾病构成与用药情况,为进一步研究提供基线数据。方法采取问卷调查结合专题访谈,收集该院2009年度住院病历和用药记录,按国际疾病分类(ICD-10)标准对出院记录的第一诊断进行分类,并按剂型、药理作用、金额、住院科室整理、分析住院药品使用情况。内容包括住院患者一般信息、出院诊断名、住院费用、所用药品金额等,应用Excel软件进行数据整理和统计分析。结果①该院2009年度住院病例共4335人次,女性多于男性(55.59%vs.44.1%),住院病例疾病谱分为18类,占ICD-10标准分类的85%。②前5位系统疾病分别是呼吸系统疾患、消化系统疾患、泌尿生殖系统疾患、损伤与中毒、妊娠分娩和产褥期疾患,共3531人次,占总住院人次的81.45%。其中,除损伤与中毒外,其余4位系统疾患的住院病人均为女性多于男性。③前15位单病种依次为:慢支炎急发、上呼吸道感染、急性支气管炎、肺炎、急性胃肠炎、慢性支气管炎、泌尿道结石、急性阑尾炎、慢性胃炎、急性胃炎、椎基底动脉供血不足、剖宫产、骨折、急性荨麻疹和梅尼埃病。④前15位单病种患者构成累计达59.81%,包括6种慢性疾病,9种急性疾病,住院人次数构成比分别为21.81%和38%,慢性病的各项平均费用均高于急性病。⑤西药金额构成比占80%～90%,抗微生物类药物和调节水、电解质类药物在内儿科、外妇科按金额排序均排名前2位。结论①2009年该院住院病例总体疾病负担主要集中在25～59岁和60岁及以上的两个年龄段,主要是呼吸和消化系统疾病,且以急性病为主。②2009年度永安中心卫生院住院部常见疾病除肺炎、泌尿道结石、尿潴留、中毒与损伤及脑梗塞男多于女外,其余疾病均为女多于男。③2009年度该院育龄住院人员剖宫产者为顺产者的4.24倍,其合理性值得关注。④按金额排位,常用药物涉及4类药和1类疫苗,与主要疾病负担一致。⑤应重点监管乡院用药金额高或频度大的药物及其合理使用。⑥2009版国家基本药物目录中0.9%氯化钠注射液、5%葡萄糖注射液、头孢呋辛等药物符合该院住院患者治疗需要。
Objective To investigate the composition and medication of hospitalized diseases in 2009 Yong’an Center Hospital of Shuangliu County, Sichuan Province, and to provide baseline data for further research. Methods A questionnaire survey and interviews were conducted to collect the hospitalization records and medication records of the hospital in 2009. According to the International Classification of Diseases (ICD-10), the first diagnosis of discharge records was classified. According to the dosage forms, pharmacological effects, amount, hospitalization department Organize, analyze hospital use of drugs. Contents include general information of inpatients, name of diagnosis of discharge, cost of hospitalization, amount of medicines used, etc., and Excel software for data sorting and statistical analysis. Results ① There were 4335 inpatients in hospital in 2009, with more women than men (55.59% vs.44.1%). Inpatient disease spectrum was classified into 18 categories, accounting for 85% of ICD-10 standard classification. ② The top 5 diseases were respiratory diseases, digestive diseases, genitourinary diseases, injuries and poisoning, pregnancy and childbirth and puerperal diseases, a total of 3531 people, accounting for 81.45% of the total number of inpatients. Among them, in addition to injury and poisoning, the remaining four patients with systemic diseases inpatients are more women than men. ③ The top 15 single diseases were as follows: acute mycoplasma, upper respiratory tract infection, acute bronchitis, pneumonia, acute gastroenteritis, chronic bronchitis, urolithiasis, acute appendicitis, chronic gastritis, acute gastritis, vertebrobasilar Artery insufficiency, cesarean section, fractures, acute urticaria and Meniere’s disease. ④ The first 15 single disease patients accounted for a total of 59.81%, including 6 kinds of chronic diseases, 9 kinds of acute diseases, the number of inpatients was 21.81% and 38%, respectively. The average cost of chronic diseases was higher than that of acute diseases. ⑤ western medicine constitute the proportion of the amount of 80% to 90%, antimicrobial drugs and regulate water, electrolytes, including pediatric, gynecological according to the amount of the top two rankings. Conclusion ① In 2009, the overall disease burden of inpatient cases in this hospital mainly concentrated in two age groups of 25- 59 years old and 60 years old and above, mainly respiratory and digestive system diseases, and mainly acute diseases. (2) In 2009, the common diseases of inpatient department of Yongan Center Hospital were more than those of male, except pneumonia, urinary tract stones, urinary retention, poisoning, injury and cerebral infarction. ③ In 2009, the cesarean section of hospitalized children of childbearing age was 4.24 times of that of the cesarean section. Its rationality deserved attention. ④ according to the amount of rank, commonly used drugs involving four types of drugs and type 1 vaccine, consistent with the burden of major diseases. ⑤ should focus on the regulation of rural hospital drug amount of high frequency or frequency of rational use of drugs. ⑥2009 version of the national essential drugs list 0.9% sodium chloride injection, 5% glucose injection, cefuroxime and other drugs in line with the hospital for treatment of patients with needs.