-
摘要:
目的 分析2011―2017年北京市院前急救创伤患者的流行病学特征,为制定全面综合的创伤防控措施提供理论依据。 方法 收集2011―2017年北京市急救中心的急救创伤病例,针对不同创伤原因,分别从不同人群、时间和空间的角度对病例进行描述性流行病学分析。 结果 本研究共纳入593 453例创伤患者,男女比例为1.40:1,高发年龄段为35~64岁,占总例数的36.63%;其次为15~34岁,占总例数的31.96%。按致伤原因分类,交通事故伤占比最大(28.19%)。 < 65岁人群以交通事故为主要致伤原因,≥65岁人群以跌倒为主要致伤原因。创伤患者例数总体呈逐年增长趋势,且城区多于郊区。创伤发生与人群活动密切相关,白天明显多于夜晚,上午7:00-8:00是跌倒伤和交通事故伤发生的高峰期。 结论 北京市院前创伤急救具有较明显的人群、时间和空间分布特征,对于指导医院急救资源合理配置以及制定有效的创伤防控措施具有一定的参考意义。 Abstract:Objective To analyze the epidemiological characteristics of pre-hospital emergency trauma patients in Beijing from 2011 to 2017 and to provide a theoretical basis for the formulation of comprehensive trauma prevention and control measures. Methods Data on first-aid trauma cases from 2011 to 2017 were collected from the Beijing Emergency Medical Center. Data were analyzed by descriptive epidemiological methods from population, time, and space angles while taking various causes of trauma into account. Results A total of 593 453 trauma patients were enrolled in this study. The ratio of male to female was 1.40:1. The age group of the highest incidence amount was 35-64 years old, with a percentage of 36.63%; Followed by 15-34 years old, with a percentage of 31.96%. Classified by the cause of the injury, traffic accidents accounted for the largest proportion of 28.19%. Traffic accidents were the leading cause of injury in people under 65 years old. Moreover, falls were the leading cause of injury in people aged 65 and over. Generally speaking, the number of trauma patients increased significantly by year. There were more patients in urban areas than in the suburbs. The occurrence of trauma was closely related to the activity level of the group. It was more during the day than at night, especially from 7 am to 8 am, which is the peak period of fall injury and traffic accidence injury. Conclusions Pre-hospital emergency trauma in Beijing has apparent characteristics of population, time, and space distribution, which is of considerable significance to guide the rational allocation of hospital first-aid resources and to formulate effective trauma prevention and control measures. -
Key words:
- Prehospital care /
- Trauma /
- Epidemiology
-
表 1 2011―2017年北京市急救创伤人群的不同致伤原因分布[n (%)]
Table 1. Proportion of causes of first-aid trauma in Beijing from 2011 to 2017 among different groups[n (%)]
受伤类型 例数(n) 性别 年龄(岁) 性别/年龄未知 男 女 ≤14 15~ 35~ ≥65 交通事故 167 300(28.19) 61 215(10.32) 41 491(6.99) 4 170(0.97) 44 169(10.22) 44 553(10.31) 9 814(2.27) 64 594(10.88) 跌倒伤 148 050(24.95) 63 364(10.68) 63 450(10.69) 2 714(0.63) 19 383(4.49) 38 149(8.83) 66 568(15.41) 21 236(3.58) 打砸伤 46 539(7.84) 22 956(3.87) 8 430(1.42) 234(0.05) 16 252(3.76) 13 668(3.16) 1 232(0.29) 15153(2.55) 其他原因 11 361(1.91) 4 776(0.80) 2 599(0.44) 1 165(0.27) 2 395(0.55) 2 800(0.65) 1 015(0.23) 3986(0.67) 坠落伤 7 114(1.20) 4 063(0.68) 1 044(0.18) 191(0.04) 2 176(0.50) 2 413(0.56) 327(0.08) 2 007(0.34) 机器伤 299(0.05) 237(0.04) 39(0.01) 13(0.00) 105(0.02) 140(0.03) 18(0.00) 23(0.00) 未知 212 790(35.86) 95 219(16.04) 63 193(10.65) 6 980(1.62) 53 603(12.41) 56 538(13.09) 4 1291(9.56) 54 378(9.16) 合计 593 453(100.00) 251 830(42.43) 180 246(30.37) 15 464(3.58) 138 083(31.96) 158 261(36.63) 120 265(27.83) 161 377(27.19) -
[1] World Health Organization. The top 10 causes of death[R/OL]. (2018-05-24)[2019-03-25].https://www.who.int/en/news-room/fact-sheets/detail/the-top-10-causes-of-death. [2] 阿不都外力·赛买提, 凯撒尔·热合木, 肖开提·依不拉音.新疆乌鲁木齐市某三甲医院8324例院前急救创伤患者救治及流行病学特征[J].临床急诊杂志, 2017, 18(3):233-236. DOI: 10.13201/j.issn.1009-5918.2017.03.019.Abuduwaili S, Kaisaier R, Xiaokaiti Y. An analysis for the epidemiological characteristics and trauma care of 8324 trauma patients in Xinjiang Medical University First Affiliated Hospital Trauma Centre[J]. J Clin Emerg, 2017, 18(3):233-236. DOI: 10.13201/j.issn.1009-5918.2017.03.019. [3] 宇传华, 季洁, 张干深, 等.中国人寿命死因与健康危险因素——全球疾病负担研究最新结果[J].中国卫生统计, 2015, 32(1):181-182. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgwstj201501061Yu CH, Ji J, Zhang GS, et al. Life span, cause of death and health risk factors in China-Latest results of global burden of disease research[J]. Chin J Health Stat, 2015, 32(1):181-182. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgwstj201501061 [4] 杨功焕. 《中国人群死亡及其危险因素:流行水平、趋势和分布》的主要发现[J].医学与哲学(人文社会医学版), 2007, 28(6):1-5. http://www.cqvip.com/QK/71135X/201107/24651725.htmlYang GH. The main findings on the death causes and their risk factors in Chinese population:prevalence, trend and distribution[J]. Med Philos, 2007, 28(6):1-5. http://www.cqvip.com/QK/71135X/201107/24651725.html [5] Pfortmueller CA, Lindner G, Exadaktylos AK. Reducing fall risk in the elderly:risk factors and fall prevention, a systematic review[J]. Minerva Med, 2014, 105(4):275-281. http://www.ncbi.nlm.nih.gov/pubmed/24867188 [6] 胡嫣平, 傅华, 吴春香. 2002-2009年上海市普陀区伤害死亡流行病学分析[J].中华疾病控制杂志, 2011, 15(6):535-537. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201106025.htmHu YP, Fu H, Wu CX. Analysis on death from injuries from 2002 to 2009 in Putuo district, Shanghai[J]. Chin J Dis Control Prev, 2011, 15(6):535-537. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201106025.htm [7] 邓晓, 李镒冲, 王丽敏, 等. 2010年我国成人道路交通伤害行为危险因素流行特点[J].中华疾病控制杂志, 2013, 17(10):837-840, 844. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201310004.htmDeng X, Li YC, Wang ML, et al. Study on behavioral risk factors of traffic injury in Chinese adults, 2010[J]. Chin J Dis Control Prev, 2013, 17(10):837-840, 844. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201310004.htm [8] FoudaMbarga N, Abubakari AR, Aminde LN, et al. Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes:a systematic review and meta-analysis of cohort studies[J]. BMC Public Health, 2018, 18(1):1413. DOI: 10.1186/s12889-018-6280-1. [9] 梅丹, 许放, 何静, 等.大连市机动车交通伤害的流行病学分析[J].中华疾病控制杂志, 2010, 14(10):974-976. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201010016.htmMei D, Xu F, He J, et al. The epidemiological analysis of motor traffic in Dalian city[J]. Chin J Dis Control Prev, 2010, 14(10):974-976. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201010016.htm [10] 周海滨, 刘小利, 彭绩. 2006-2009年深圳市住院伤害流行特征及住院费用研究[J].中华疾病控制杂志, 2010, 14(10):1004-1007. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201010025.htmZhou HB, Liu XL, Peng J. Study on the epidemiological characteristics and hospitalization expenses of injury inpatients in Shenzhen from 2006 to 2009[J]. Chin J Dis Control Prev, 2010, 14(10):1004-1007. http://www.cnki.com.cn/Article/CJFDTotal-JBKZ201010025.htm [11] 北京市统计局.六次人口普查人口基本情况[R/OL]. (2010-11-01)[2019-03-25]. http://tjj.beijing.gov.cn/nj/main/2017-tjnj/zk/indexch.htm.Beijing Municipal Bureau of Statistics. The basic information of the population in the six census[R/OL]. (2010-11-01)[2019-03-25]. http://tjj.beijing.gov.cn/nj/main/2017-tjnj/zk/indexch.htm. [12] Verma SK, Willetts JL, Corns HL, et al. Falls and fall-related injuries among community-dwelling adults in the United States[J]. PLoS One, 2016, 11(3):e0150939. DOI: 10.1371/journal.pone.0150939. [13] Cordellieri P, Baralla F, Ferlazzo F, et al. Gender effects in young road users on road safety attitudes, behaviors and risk perception[J]. Front Psychol, 2016, 7:1412. DOI: 10.3389/fpsyg.2016.01412. [14] 冀翠华, 王丽萍, 王式功, 等.北京市创伤发病特征及其与气象条件的关系分析[J].兰州大学学报(自然科学版), 2015, 51(1):98-102. DOI: 10.13885/j.issn.0455-2059.2015.01.015.Ji CH, Wang LP, Wang SG, et al. Analysis of trauma incidence characteristics in Beijing and its relationship with meteorological conditions[J]. J Lanzhou Univ Nat Sci, 2015, 51(1):98-102. DOI: 10.13885/j.issn.0455-2059.2015.01.015. [15] 王仁颖, 王运兴, 张静.上海某院急诊创伤的流行病学特征研究[J].上海医药, 2018, 39(22):41-44. DOI: 10.3969/j.issn.1006-1533.2018.22.015.Wang RY, Wang YX, Zhang J. Epidemiological characteristics of emergency trauma in a hospital in Shanghai[J]. Shanghai Med Pharm J, 2018, 39(22):41-44. DOI: 10.3969/j.issn.1006-1533.2018.22.015. [16] 杜晶, 蒋超, 徐中杰, 等.上海市某城区近5年来院前急救患者疾病谱及流行病学变化分析[J].临床急诊杂志, 2018, 19(12):821-824, 829. DOI: 10.13201/j.issn.1009-5918.2018.12.004.Du J, Jiang C, Xu ZJ, et al. Analysis of disease spectrum and epidemiological changes of Shanghai pre-hospital emergency in the past 5 years[J]. J Clin Emerg, 2018, 19(12):821-824, 829. DOI: 10.13201/j.issn.1009-5918.2018.12.004 [17] 廖英, 王玉林, 刘华章, 等. 2014-2016年广州市老年人跌倒/坠落伤害特征及其影响因素分析[J].中华疾病控制杂志, 2018, 22(2):117-121. DOI: 10.16462/j.cnki.zhjbkz.2018.02.004.Liao Y, Wang YL, Liu HZ, et al. Characteristics of unintentional fall-related injuries and the related factors among the elderly in Guangzhou from 2014 to 2016[J]. Chin J Dis Control Prev, 2018, 22(2):117-121. DOI: 10.16462/j.cnki.zhjbkz.2018.02.004.