3年间昆明地区消化系疾病住院病种分析

目的了解昆明地区近3 a消化系疾病住院病种变化的特点和规律,分析原因,为昆明地区消化系疾病临床工作、预防保健及合理配置卫生资源提供依据.方法对昆明市卫生局人才中心提供的政府办医院出院病人疾病转归情况统计报表消化系疾病部分进行分析,并结合调查昆明地区5家规模最大的＂三甲医院＂消化系疾病住院病种详细统计资料,了解2007年至2009年昆明地区消化系疾病出院病人病种变化.采用ICD10进行疾病分类,了解2007年至2009年昆明市消化系疾病住院病人占所有病种出院病人的结构比,掌握近3a按ICD10分类主码排位前7位的消化系疾病病种变化规律.结果昆明市2007年政府办医院消化系疾病住院病例数为46 572例,占所有住院病例病种的19.3%,居第二位,排位前7位的病种为胆囊结石及胆囊炎、肝炎后肝硬变、胃及十二指肠溃疡、慢性浅表性胃炎、急性胰腺炎、结肠息肉、结肠预激综合症;2008年为59 050例,占16.9%,居第二位.排位前7位的病种与2007年相同,仅结肠息肉排位在急性胰腺炎之前;2009年为65 889例,占12.1%,居第三位.排位前7位的病种前4种与2007年相同,第五位为结肠预激综合征,第六位为结肠息肉,急性胰腺炎排至第七位.县区级医院消化系疾病住院结构比高于省市级医院.结论消化系疾病在2007年至2009年是昆明地区的常见多发病,但住院病种结构比有逐年下降趋势.县区级消化系疾病住院结构比较高,提示城郊及农村地带消化系疾病发生率较城市多.在消化系疾病出院病人中,最多见的病种为胆结石及胆囊炎,说明昆明地区为结石高发地区;而肝炎后肝硬化仍是本地区主要消化系疾病;消化性溃疡、慢性胃炎在3 a中住院结构比较稳定,但绝对数有逐年下降趋势;结肠息肉及结肠预激综合症结构比有逐年上升趋势,提示潜在肿瘤及功能性疾病的发病有所增加.本次调查分析获取了昆明地区消化系疾病谱现状及变化趋势,为消化系疾病卫生防御及医疗资源配置提供了依据.

Analysis of Diseases Types in Hospitalized Patients Because of Digestive System Diseases in Kunming in Recent Three Years

Objective To investigate characteristics and patterns of the different types of disease in hospitalized patients because of digestive system diseases,analyze the causes of these diseases and provid the information for the clinical practices,disease prevention and optimization of medical resources arrangement.Methods Based on the data on human digestive system diseases in patients from government owned hospitals（information provided by the human resources center of Kunming Health Bureau）,together with the investigation on digestive system disease types from 5 biggest Grade A tertiary general hospital in Kunming City,we clarified the changes of types of digestive system related diseases during 2007-2009.Using the ICD10 for the classification of these diseases,the ratio of these disease in dischared patients was investigated and the trends for the top 7 according to ICD10 classified diseases was pinpointed.Results In 2007,the hospitalized patients diagnosed with digestive system related disease were 46 572 cases in total,which accounted for 19.3% and the second biggest group of all hospitalized patients.The top 7 disease types were gallstones and cholecystitis,cirrhosis after hepatitis,gastric and duodenal ulcers,chronic gastritis,acute pancreatitis,colon polyps,colon pre-bowel syndrome.In 2008,totally 59,050 cases were documented,accounted for 16.9% of all hospitalized paitents and ranking the second.The top 7 diseases types were similar,excepting that colon polyps disease occurs more often than acute pancreatitis.In 2009,totally 65,899,accounted for 12.1% of total hospitalized patients and ranking the third.The top 7 disease types were gallstones and cholecystitis,cirrhosis after hepatitis,gastric and duodenal ulcers,chronic gastritis,colon pre-bowel syndrome,colon polyps,acute pancreatitis.Generally,there was a higher percentage of digestive system related disease patients in county level hospitals than province/city levels of hospitals.Conclusion The digestive system related diseases are very common in Kunming district during 2007～2009,with a general trend of reduction percentage in hospitalized patients in recent 3 years.In the county level hospitals,there is a higher frequency of digestive system related diseases,suggesting a higher occurrence of such type of diseases in the suburb and villages.Among those hospitalized patients,the most common diseases are gallstones and cholecystitis,indicating Kunming district is a high risky area for gallstones.The major digestive system disease is cirrhosis after hepatitis in Kunming.The ratios of the peptic ulcer and chronic gastritis remain stable,but with a reduction in the absolute number of patient cases.The ratios of colon polyps and colon pre-bowel syndrome are increased gradually during these 3 years,suggesting an increase of the tumor and function related disease occurrences.Finally our study here investigated the digestive system disease spectrum and occurrence trends,which lays a good foundation for the future health prevention and optimization of the medical resources arrangements.