利用多种指标对哈尔滨市人群生命质量的评价

采用多种指标综合分析 ,对哈尔滨市区的人群生命质量进行了评价     

老年细菌性肝脓肿的临床分析

目的 :分析老年人细菌性肝脓肿的临床特点 ,治疗方法和转归。方法 :采集1992～2001年本院全部细菌性肝脓肿70例 ,回顾性地比较中青年对照组 (60岁以下)和≥60岁的老年病人的临床要点。结果 :临床均以发热为主要症状 ,与对照组相比 ,老年组中左叶脓肿比例稍多 (30 8%比16 1% ) ,两组的脓肿最大径相似 ,患糖尿病 (41 0%比22 5% )和胆道结石 (28 2%和16 7% )等基础疾病较多。老年组的平均最高白细胞计数较高 ,血清白蛋白浓度明显较低(30 3±6 3)g/L比 (34 1±5 6)g/L。老年组有3例死亡(7 1% ) ,对照组无死亡。结论 :老年细菌性肝脓肿病人属较重的感染。老年发热病人应及早做超声和 (或)CT检查。应重视血和引流液的细菌培养 ,特别注意肺炎克雷伯菌感染 ,尽早采用有效的抗菌药物。穿刺引流是安全有效的治疗措施 ,老年人的细菌性肝脓肿预后取决于基础疾病。     

Temperature and Daily Mortality in Shanghai： A Time-series Study

Objective To investigate the association between temperature and daily mortality in Shanghai from June 1, 2000 to December 31,2001. Methods Time-series approach was used to estimate the effect of temperature on daily total and cause-specific mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for long-term time trend, season and other variables. We also controlled for day of the week. Results A gently sloping V-like relationship between total mortality and temperature was found, with an optimum temperature (e.g.temperature with lowest mortality risk) value of 26.7℃ in Shanghai. For temperatures above the optimum value, total mortality increased by 0.73% for each degree Celsius increase; while for temperature below the optimum value, total mortality decreased by 1.21% for each degree Celsius increase. Conclusions Our findings indicate that temperature has an effect on daily mortality in Shanghai, and the time-series approach is a useful tool for studying the temperature-mortality association.     

食管癌患者手术后死亡病例回顾和原因分析

目的:进一步明确食管癌患者手术死亡率,探讨不同时期食管癌手术死亡的主要原因.方法:回顾性分析我院自1954年1月开展食管外科至2003年12月50年间经外科成功切除食管癌手术2 572例.按年代作统计,将前32年(1954年1月～1985年12月)和后18年(1986年1月～2003年12月)分为A、B两组,并就其术后死亡116例原因进行探讨分析.结果:A组手术死亡44例,死亡率为8.15%(44/540).B组手术死亡72例,死亡率为3.54%(72/2 032).A、B两组死亡原因分析差异不大,最常见的死亡原因是吻合口瘘,其次是呼吸衰竭和呼吸循环衰竭;再次是心肌梗塞.结论:吻合口瘘、呼吸衰竭、呼吸循环衰竭、心血管病变(心肌梗塞心脏骤停)是本组食管癌术后死亡的主要原因.     

闭合性胰腺损伤外科治疗54例

目的探讨闭合性胰腺损伤的治疗方法及死亡原因。方法对54例闭合性胰腺损伤病例进行回顾性分析，按胰腺损伤的程度，找出合适的治疗方式，并对死亡原因展开分析。结果54例中除Ⅰ、Ⅱ度胰腺损伤的部分病人外，其余病人都进行手术治疗。Ⅰ、Ⅱ、Ⅲ、Ⅳ度胰腺损伤的死亡率分别是0，7．1％，16．6％．28．5％。结论根据胰腺损伤的程度，选择适当手术方式。死亡率与胰腺损伤的严重程度和多发伤密切相关。     

马鞍山市2373例居民伤害死亡原因灰关联分析

目的 :对马鞍山市 1987～ 2 0 0 0年居民伤害死亡原因进行分析 ,为居民伤害死亡的预防和控制提供科学依据。方法 :采用新灰关联分析法 ,将总的意外死亡序列作为参考序列 X0 ,车辆交通事故等 14类意外伤害死亡序列分别作为被比较序列 X1 ～ X1 4。通过分析各被比较序列与参考序列的接近程度 (关联度 Ri) ,推断各类意外伤害的死因顺位。结果 :自杀、机动车交通事故、意外跌落关联度分别为 0 .96 9、 0 .95 1、 0 .876 ,是前 3位死因。结论 :该市应加强对居民自杀、机动车交通事故、意外跌落等伤害死亡的预防和控制     

1981-2003年大连市市区居民恶性肿瘤死亡分析

目的分析1981--2003年大连市区居民恶性肿瘤死亡率、减寿年数（PYLL）和减寿率的变化趋势。方法用PYLL相关指标计算法和EPIINFOR卡方，对不同性别、年代恶性肿瘤死亡状况及其死亡率做线性趋势分析。结果1981—2003年间男、女性恶性肿瘤死亡率均呈明显上升趋势，男、女性的减寿水平则呈明显下降趋势；PYLL标化率的年龄分布显示，45岁以后男性比女性平均减寿年数多，但两性变动趋势一致，均在55-64岁阶段出现一个高峰。男性恶性肿瘤死亡前5位依次为肺癌、肝癌、胃癌、食管癌、结直肠肛门癌；女性为肺癌、胃癌、肝癌、结直肠肛门癌、乳腺癌。经PYLL率调整，男性寿命损失的排序是肝癌、肺癌、胃癌、白血病、结直肠肛门癌；女性则为肺癌、胃癌、白血病、乳腺癌、结直肠肛门癌。结论大连市市区居民男性恶性肿瘤的“超前死亡”比女性严重，其死亡年龄有后移现象，男性寿命损失的高峰年龄较女性提前。     

浙江省萧山区1988—2004年交通伤害死亡流行趋势和疾病负担分析

目的了解1988—2004年萧山区居民交通伤害死亡的变化趋势、地区特点和疾病负担,为有关部门制定预防和控制交通伤害措施提供科学依据。方法使用全死因登记监测资料,描述交通伤害死亡水平及其变化趋势,并计算交通伤害死亡率、潜在减寿年数(PYLL)和潜在工作减寿年数(WPYLL)。结果萧山区1988—2004年交通伤害累计死亡3543人,年平均死亡率为23.15/10万,占伤害死亡的36.86%,居伤害死亡第1位;居民交通伤害死亡水平以每年3.80%的速度递增;交通伤害死亡水平与机动车数量呈正强相关;17a来交通伤害死亡平均减寿30.88人.a,20～59岁年龄段的PYLL标化率和WPYLL标化率均高于其他年龄段,是交通伤害的高危人群。结论17a来交通伤害死亡率上升明显,交通伤害是青壮年的主要死因,交通伤害导致的PYLL和WPYLL是明显的,带来了沉重疾病负担,应引起全社会特别是政府部门的重视,并针对其死亡特点,制定有效的控制策略。     

Mortality in epilepsy

Both community-based studies and reports from more selected epilepsy populations consistently reveal persons with epilepsy to have a mortality rate two to three times that of the general population. This increased rate is most pronounced in patients with remote symptomatic epilepsy, although many studies also report a significant excess mortality also among those with idiopathic epilepsy. The highest standardized mortality ratios (SMR) are seen in young age groups, mainly due to the low expected mortality in children, and during the first 5-10 years after diagnosis. Many of these observations suggest that the higher mortality is partly related to the underlying disorder causing epilepsy rather than a direct consequence of the seizures. For example, mortality in cerebrovascular diseases is increased, with SMRs ranging from 1.8 to 5.3 in the various studies. Deaths due to neoplasms, and in particular brain tumors, is also increased among patients with epilepsy. Accidents, status epilepticus, and sudden unexpected death (SUD) are more directly seizure-related causes of death. The incidence of such deaths vary considerably depending on the population being studied. While rare among patients with new-onset epilepsy, seizure-related deaths may account for up to 40% of all deaths in patients with chronic epilepsy. SUD is probably the most frequent seizure-related cause of death among young adults with epilepsy, with an SMR more than 20 compared with the general population. Seizure-induced autonomic cardiorespiratory effects have been suggested, but the mechanisms behind SUD are far from fully understood. It appears, however, that the risk of SUD is closely related to seizure frequency, being 40 times higher in patients who continue to have seizures than in those who are seizure-free.     

Human resources and access to maternal health care.

The lack of human resources is one of the main bottlenecks to achieving the Millennium Development Goals on maternal and child health. A coherent national policy, recognized across government, needs to be in place to overcome this especially in countries severely affected by HIV/AIDS. Such a policy should cover selection of pre-service students, the qualifications of trainers and training sites, supportive supervision, career path development, a package of carefully thought-out incentives for the retention of staff, strategies for interaction with communities, and an agreed-upon health staff HIV/AIDS policy. Without such coherent human resource planning, a large number of countries will fail to reduce maternal and newborn mortality.