2013-2017年北京市120院前急救患者疾病谱特征分析

赵思宇; 曹昱; 雷燕妮; 柳芳超; 邵石雨; 刘珏; 聂冬妮; 杨楠楠; 刘民

doi:10.16462/j.cnki.zhjbkz.2019.04.021

2013-2017年北京市120院前急救患者疾病谱特征分析

doi: 10.16462/j.cnki.zhjbkz.2019.04.021

1.
100191 北京, 北京大学公共卫生学院流行病与卫生统计学系
2.
100053 北京, 北京市卫生健康委员会
3.
100031 北京, 北京急救中心

详细信息

通讯作者:
刘民, E-mail: liumin@bjmu.edu.cn

中图分类号: R181.22
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出版历程
- 收稿日期: 2019-01-08
- 修回日期: 2019-02-22
- 刊出日期: 2019-04-10

Analysis of the disease spectrum of Beijing 120 prehospital emergency patients from 2013 to 2017

1.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
2.
Beijing Municipal Health Commission, Beijing 100053, China
3.
Beijing Emergency Medical Center, Beijing 100031, China

More Information

Corresponding author: LIU Min, E-mail: liumin@bjmu.edu.cn

摘要

摘要: 目的了解北京市院前急救患者疾病谱特征，为合理配置院前急救资源、完善院前急救服务提供依据。方法利用北京急救中心120调度指挥系统急救出车数据，研究2013-2017年北京市120院前急救患者的疾病谱，分析不同年份、性别、年龄的患者疾病谱的差异和不同疾病的时间分布特征。结果 2013-2017年北京市120院前急救患者共1 643 375人，疾病谱前三位疾病依次为：损伤和中毒（29.63%）、循环系统疾病（18.37%）、神经系统疾病（15.80%），5年间疾病顺位无变化。不同年龄段、性别患者疾病谱有差异。呼叫时间在春、夏、秋、冬季的分别占25.23%、24.97%、25.05%、24.75%，一天中08：00~09：59（12.41%）、12：00~13：59（10.05%）、14：00~15：59（9.91%）呼叫的最多，不同疾病的高发月份和时刻有差异。结论近年来北京市院前急救服务需求量不断增大，应加强对各年龄段人群尤其是男性外伤的防范和对老年人群慢性疾病突发情况的预防与应对能力，根据不同疾病的呼叫高峰月份和时间段合理配置院前急救资源。
- 院前急救 /
- 疾病谱 /
- 流行病学
Abstract: Objective To understand the disease spectrum of prehospital emergency patients in Beijing, so as to provide basis for rational allocation of prehospital emergency care resources and for improvement of prehospital emergency care. Methods Emergency dispatch database from 120 dispatching command system of Beijing Emergency Medical Center to was used study the disease spectrum of 120 prehospital emergency patients from 2013 to 2017 in Beijing, and were analyzed the differences of disease spectrum among patients of different years, genders and ages, and the time distribution of different diseases. Results From 2013 to 2017 in Beijing, 1 643 375 patients used 120 prehospital emergency care. The top 3 diseases of the disease spectrum were: injury and poisoning (29.63%), diseases of the circulatory system (18.37%), and diseases of the nervous system (15.80%). The sorting of diseases remained unchanged during the 5 years. The disease spectrums were different among different age groups and gender groups. The calls in spring, summer, autumn and winter accounted for 25.23%, 24.97%, 25.05% and 24.75% respectively. Most calls were made from 08:00 to 09:59 (12.41%), 12:00 to 13:59 (10.05%), and 14:00 to 15:59 (9.91%) during a day. The peak months and hours of different diseases were different. Conclusions The demand for prehospital emergency care has been increasing in Beijing in recent years. It is important to strengthen the prevention of injuries among all ages, especially male, and to improve the prevention and response capacity for acute attack of chronic diseases among older people. Prehospital emergency care resources should be rationally allocated according to the peak months and hours of calls.
- Prehospital emergency care /
- Disease spectrum /
- Epidemiology

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图 1 2013-2017年北京市120院前急救患者疾病谱

Figure 1. The disease spectrum of Beijing 120 prehospital emergency patients from 2013 to 2017

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图 2 2013-2017年北京市120院前急救患者疾病谱前十位疾病的月份分布

Figure 2. The month distribution of the top ten in the disease spectrum of Beijing 120 prehospital emergency patients from 2013 to 2017

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图 3 2013-2017年北京市120院前急救患者疾病谱前十位疾病的时刻分布

Figure 3. The hour distribution of the top ten in the disease spectrum of Beijing 120 prehospital emergency patients from 2013 to 2017

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表 1 2013-2017年北京市120院前急救患者疾病谱及顺位[n(%)]

Table 1. The disease spectrum and sorting of Beijing 120 prehospital emergency patients from 2013 to 2017[n(%)]

疾病种类	2013	2014	2015	2016	2017	合计
疾病种类	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	顺位
损伤和中毒	91 181(28.91)	95 454(29.25)	91 011(29.35)	99 458(29.96)	109 892(30.57)	486 996(29.63)	1
循环系统	56 896(18.04)	57 654(17.67)	58 389(18.83)	62 004(18.68)	66 881(18.60)	301 824(18.37)	2
神经系统	50 636(16.05)	50 479(15.47)	48 063(15.50)	52 761(15.89)	57 664(16.04)	259 603(15.80)	3
呼吸系统	25 551(8.10)	27 825(8.53)	27 931(9.01)	30 131(9.08)	32 421(9.02)	143 859(8.75)	4
消化系统	23 393(7.42)	24 191(7.41)	23 558(7.60)	23 496(7.08)	26 637(7.41)	121 275(7.38)	5
产科	7 600(2.41)	10 116(3.10)	6 640(2.14)	9 107(2.74)	8 968(2.49)	42 431(2.58)	6
泌尿生殖系统	3 994(1.27)	4 716(1.45)	4 890(1.58)	4 988(1.50)	5 338(1.48)	23 926(1.46)	7
精神和行为障碍	3 754(1.19)	3 730(1.14)	4 105(1.32)	4 415(1.33)	5 050(1.40)	21 054(1.28)	8
内分泌和代谢	2 316(0.73)	2 582(0.79)	2 557(0.82)	2 634(0.79)	3 169(0.88)	13 258(0.81)	9
肿瘤	1 656(0.53)	1 718(0.53)	1 835(0.59)	1 483(0.45)	1 533(0.43)	8 225(0.50)	10
眼耳	846(0.27)	966(0.30)	844(0.27)	880(0.27)	914(0.25)	4 450(0.27)	11
血液和免疫	674(0.21)	783(0.24)	726(0.23)	709(0.21)	698(0.19)	3 590(0.22)	12
皮肤和皮下组织	421(0.13)	539(0.17)	579(0.19)	582(0.18)	604(0.17)	2 725(0.17)	13
传染病和寄生虫	290(0.09)	344(0.11)	235(0.08)	295(0.09)	306(0.09)	1 470(0.09)	14
结缔组织	125(0.04)	124(0.04)	118(0.04)	108(0.03)	108(0.03)	583(0.04)	15
其他	46 081(14.61)	45 134(13.83)	38 660(12.47)	38 923(11.72)	39 308(10.93)	208 106(12.66)	-
合计	315 414(100.00)	326 355(100.00)	310 141(100.00)	331 974(100.00)	359 491(100.00)	1 643 375(100.00)	-

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表 2 2013-2017年北京市120院前急救不同年龄患者的疾病谱及顺位

Table 2. The disease spectrum and sorting of Beijing 120 prehospital emergency patients from different age groups from 2013 to 2017

疾病	0~岁		10~岁		20~岁		40~岁		60~岁		80~99岁
疾病	n (%)	顺位	n (%)	顺位	n (%)	顺位	n (%)	顺位	n (%)	顺位	n (%)	顺位
损伤和中毒	9 375(22.08)	1	11 953(48.53)	1	123 292(43.67)	1	104 910(32.32)	1	65 049(16.67)	3	40 277(14.10)	4
循环系统	1 296(3.05)	5	1 425(5.79)	4	19 554(6.93)	5	70 822(21.82)	2	112 832(28.91)	1	63 712(22.31)	1
神经系统	7 279(17.14)	2	4 276(17.36)	2	37 699(13.35)	2	57 810(17.81)	3	69 210(17.74)	2	46 474(16.27)	3
呼吸系统	4 176(9.83)	3	1 266(5.14)	5	9 897(3.51)	6	21 150(6.52)	5	45 516(11.66)	4	48 897(17.12)	2
消化系统	2 895(6.82)	4	2 444(9.92)	3	25 638(9.08)	4	24 298(7.49)	4	29 328(7.52)	5	24 267(8.50)	5
产科	0(0.00)	15	195(0.79)	8	36 077(12.78)	3	1 089(0.34)	10	0(0.00)	15	0(0.00)	15
泌尿生殖系统	228(0.54)	8	241(0.98)	7	3 931(1.39)	7	4 520(1.39)	7	6 948(1.78)	6	6 127(2.15)	6
精神和行为障碍	82(0.19)	13	281(1.14)	6	3 663(1.30)	8	5 094(1.57)	6	5 571(1.43)	7	4 422(1.55)	7
内分泌和代谢	86(0.20)	12	117(0.48)	12	1 275(0.45)	10	2 823(0.87)	8	5 079(1.30)	8	2 777(0.97)	8
肿瘤	105(0.25)	11	132(0.54)	10	680(0.24)	11	1 877(0.58)	9	3 328(0.85)	9	1 426(0.50)	9
眼耳	260(0.61)	6	177(0.72)	9	1 308(0.46)	9	992(0.31)	11	648(0.17)	12	377(0.13)	12
血液和免疫	110(0.26)	10	126(0.51)	11	603(0.21)	12	744(0.23)	12	1 028(0.26)	10	689(0.24)	11
皮肤和皮下组织	187(0.44)	9	62(0.25)	13	328(0.12)	13	303(0.09)	13	683(0.18)	11	1 000(0.35)	10
传染病和寄生虫	229(0.54)	7	38(0.15)	14	202(0.07)	14	166(0.05)	14	296(0.08)	13	354(0.12)	13
结缔组织	6(0.01)	14	12(0.05)	15	85(0.03)	15	120(0.04)	15	228(0.06)	14	93(0.03)	14
其他	16 150(38.03)	-	1 883(7.65)	-	18 113(6.42)	-	27 882(8.59)	-	44 486(11.40)	-	44 664(15.64)	-
合计	42 464(100.00)	-	24 628(100.00)	-	282 345(100.00)	-	324 600(100.00)	-	390 230(100.00)	-	285 556(100.00)	-

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表 3 2013-2017年北京市120院前急救不同性别患者疾病谱及顺位

Table 3. The disease spectrum and sorting of Beijing 120 prehospital emergency patients from different gender groups from 2013 to 2017

疾病	男性		女性
疾病	n(%)	顺位	n(%)	顺位
损伤和中毒	248 653(32.30)	1	157 609(23.85)	1
循环系统	143 108(18.59)	2	132 204(20.00)	2
神经系统	122 266(15.88)	3	112 920(17.09)	3
呼吸系统	73 943(9.61)	4	58 823(8.90)	4
消化系统	55 347(7.19)	5	55 840(8.45)	5
产科	0(0.00)	15	39 390(5.96)	6
泌尿生殖系统	11 387(1.48)	6	11 133(1.68)	7
精神和行为障碍	9 957(1.29)	7	9 683(1.47)	8
内分泌和代谢	6 378(0.83)	8	6 008(0.91)	9
肿瘤	4 424(0.57)	9	3 220(0.49)	10
眼耳	2 490(0.32)	10	1 454(0.22)	12
血液和免疫	1 671(0.22)	11	1 683(0.25)	11
皮肤和皮下组织	1 314(0.17)	12	1 297(0.20)	13
传染病和寄生虫	720(0.09)	13	578(0.09)	14
结缔组织	196(0.03)	14	355(0.05)	15
其他	87 853(11.41)	-	68 673(10.39)	-
合计	769 707(100.00)	-	660 870(100.00)	-

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参考文献(18)

[1]	郭憬昱, 张进军. 我国急救医疗体系院前与院内衔接[J]. 中国医刊, 2014, 51(9): 10-13. DOI: 10.3969/j.issn.1008-1070.2016.09.003. Guo JY, Zhang JJ. Connection between pre-hospital and in-hospital emergency medical service in China[J]. Chin J Med, 2014, 51(9): 10-13. DOI: 10.3969/j.issn.1008-1070.2016.09.003.
[2]	北京市第十四届人民代表大会常务委员会. 北京市院前医疗急救服务条例[EB/OL]. (2017-9-8)[2018-12-24]. http://zfxxgk.beijing.gov.cn/cpq11P033/gfxwj22/2017-09/08/content_118961.shtml. Standing Committee of the 14th Beijing People's Congress. Regulations on Pre-hospital Emergency Medical Service in Beijing[EB/OL]. (2017-9-8)[2018-12-24]. http://zfxxgk.beijing.gov.cn/cpq11P033/gfxwj22/2017-09/08/content_118961.shtml.
[3]	北京市统计局, 国家统计局北京调查总队. 北京统计年鉴2018[EB/OL]. (2018)[2018-12-24]. http://tjj.beijing.gov.cn/nj/main/2018-tjnj/zk/indexch.htm. Beijing Municipal Bureau of Statictics, Survey Office of the National Bureau of Statistics in Beijing. Beijing Statistical Yearbook 2018[EB/OL]. (2018)[2018-12-24]. http://tjj.beijing.gov.cn/nj/main/2018-tjnj/zk/indexch.htm.
[4]	李智红, 于海玲. 2010年北京市120院前急救成人患者流行病学研究[J]. 实用心脑肺血管病杂志, 2013, 21(11): 43-44. DOI: 10.3969/j.issn.1008-5971.2013.11.020. Li ZH, Yu HL. Epidemiology of Beijing 120 adult patients with pre-hospital care in 2010[J]. PJCCPVD, 2013, 21(11): 43-44. DOI: 10.3969/j.issn.1008-5971.2013.11.020.
[5]	北京急救中心. 120院前急救文件汇编下册(北京)[G]. 北京: 北京急救中心, 2014. Beijing Emergency Medical Center. 120 Prehospital Emergency Care Documents Compilation Volume Ⅱ (Beijing)[G]. Beijing: Beijing Emergency Medical Center, 2014.
[6]	周海斌, 张军根, 于晓华, 等. 杭州市2000~2009年院外急救患者流行病学分析[J]. 中国急救复苏与灾害医学杂志, 2011, 6(3): 237-240. DOI: 10.3969/j.issn.1673-6966.2011.03.015. Zhou HB, Zhang JG, Yu XH, et al. Analysis of epidemiological characteristics of pre-hospital emergency patients in Hangzhou from 2000 to 2009[J]. Chin J of Emerg Resusc Disaster Med, 2011, 6(3): 237-240. DOI: 10.3969/j.issn.1673-6966.2011.03.015.
[7]	李红, 郑小坚, 卓红梅, 等. 上海市青浦地区2014年院外急救疾病谱分析[J]. 中国急救复苏与灾害医学杂志, 2016, 11(1): 17-19. DOI: 10.3969/j.issn.1673-6966.2016.01.005. Li H, Zheng XJ, Zhuo HM, et al. Analysis of disease spectrum for pre-hospital emergency treatment in Qingpu District, Shanghai in 2014[J]. Chin J of Emerg Resusc Disaster Med, 2016, 11(1): 17-19. DOI: 10.3969/j.issn.1673-6966.2016.01.005.
[8]	Christensen EF, Larsen TM, Jensen FB, et al. Diagnosis and mortality in prehospital emergency patients transported to hospital: A population-based and registry-based cohort study[J]. BMJ Open, 2016, 6(7): 1-7. DOI: 10.1136/bmjopen-2016-011558.
[9]	林全洪, 田建广, 徐耀伟, 等. 2010-2013年嘉定区院外急救儿童流行病学调查[J]. 中国急救复苏与灾害医学杂志, 2015, 10(11): 1047-1050. DOI: 10.3969/j.issn.1673-6966.2015.11.012. Lin QH, Tian JG, Xu YW, et al. Epidemiological analysis of pre-hospital emergency for pediatric patients in Jiading District, Shanghai, 2010-2013[J]. Chin J of Emerg Resusc Disaster Med, 2015, 10(11): 1047-1050. DOI: 10.3969/j.issn.1673-6966.2015.11.012.
[10]	周夕坪, 邓绍富, 张光贵, 等. 四川省绵阳市2014年院前急救数据分析[J]. 中华疾病控制杂志, 2016, 20(2): 213-214. DOI: 10.16462/j.cnki.zhjbkz.2016.02.028. Zhou XP, Deng SF, Zhang GG, et al. The data analysis of pre-hospital first aid in Mianyang City, Sichuan Province in 2014[J]. Chin J Dis Control Prev, 2016, 20(2): 213-214. DOI: 10.16462/j.cnki.zhjbkz.2016.02.028.
[11]	Jiang B, Liang S, Peng Z-R, et al. Transport and public health in China: the road to a healthy future[J]. Lancet, 2017, 390(10104): 1781-1791. DOI: 10.1016/S0140-6736(17)31958-X.
[12]	陈锋, 柯俊, 钱欣, 等. 福州市2010年中心城区社区人群的院前急救分析及策略[J]. 中华急诊医学杂志, 2013, 22(9): 971-975. DOI: 10.3760/cma.j.issn.1671-0282.2013.09.007. Chen F, Ke J, Qian X, et al. Analysis and strategies of pre-hospital emergency care for a community-based population in urban areas of Fuzhou city in 2010[J]. Chin J Emerg Med, 2013, 22(9): 971-975. DOI: 10.3760/cma.j.issn.1671-0282.2013.09.007.
[13]	张婷婷, 刘文生, 张媛, 等. 乌鲁木齐市2011-2015年院前急救流行病学调查[J]. 中国预防医学杂志, 2016, 17(7): 521-526. DOI: 10.16506/j.1009-6639.2016.07.010. Zhang TT, Liu WS, Zhang Y, et al. Epidemiological analysis of pre-hospital first aid in Urumqi in 2011-2015[J]. Chin Prev Med, 2016, 17(7): 521-526. DOI: 10.16506/j.1009-6639.2016.07.010.
[14]	Marshall RJ, Scragg R, Bourke P. An analysis of the seasonal variation of coronary heart disease and respiratory disease mortality in New Zealand[J]. Int J Epidemiol, 1988, 17(2): 325-331. DOI: 10.1093/ije/17.2.325.
[15]	Pan WH, Li LA, Tsai MJ. Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly Chinese[J]. Lancet, 1995, 345(8946): 353-355. DOI: 10.1016/S0140-6736(95)90341-0.
[16]	Xu B, Liu H, Su N, et al. Association between winter season and risk of death from cardiovascular diseases: A study in more than half a million inpatients in Beijing, China[J]. BMC Cardiovasc Disord, 2013, 13(93): 1-7. DOI: 10.1186/1471-2261-13-93.
[17]	Fares A. Global patterns of seasonal variation in gastrointestinal diseases[J]. J Postgrad Med, 2013, 59(3): 203-207. DOI: 10.4103/0022-3859.118039.
[18]	潘爱群, 马福来, 张贵田. 1998~2006年唐山市院前急救疾病谱的变化原因分析和应对措施探讨[J]. 中国急救医学, 2007, 27(10): 952-953. DOI: 10.3969/j.issn.1002-1949.2007.10.028. Pan AQ, Ma FL, Zhang GT. Analysis on the causes of changes in disease spectrum of pre-hospital emergency medical service in Tangshan from 1998 to 2006 and discussion on the countermeasures[J]. Chin J Crit Care, 2007, 27(10): 952-953. DOI: 10.3969/j.issn.1002-1949.2007.10.028.