呼吸重症监护病房住院患者疾病构成与死亡原因分析

目的分析呼吸重症监护病房患者疾病构成与死亡原因分布特征,为重症呼吸系统疾病的诊治与防控提供参考资料。方法回顾性分析沈阳市某三级甲等医院呼吸重症监护病房2017年1月1日-2019年12月31日收治的1653例患者病案首页资料,收集不同性别、年龄组住院患者的主要疾病构成和死因分布等信息进行统计分析。结果呼吸重症监护病房排名前3位疾病依次为肺炎(18.73%)、肺部感染(14.51%)和肺栓塞(8.63%)。男女性别比为1.19:1。男性肺部感染(χ^2=6.533,P=0.011)、慢性阻塞性肺疾病急性加重(χ^2=4.017,P=0.045)和吸入性肺炎(χ^2=10.453,P=0.001)的构成比高于女性。65岁及以上老年患者占比62.97%,65岁以上年龄组慢性支气管炎急性发作和慢性阻塞性肺疾病急性加重的构成比高于65岁以下患者。肺部感染是呼吸重症监护病房患者的首要死亡原因。结论某院呼吸重症监护病房疾病以肺炎、肺部感染和肺栓塞为主,65岁以上老年患者居多。建议有关部门加强对肺部感染及其相关危险因素的监测,提升重症呼吸系统疾病的诊疗水平和抢救能力。

Analysis on Disease Constitution and Death Cause of Inpatients in Respiratory Intensive Care Unit of a Hospital

Objectives The purpose of this study was to analyze the characteristics of disease composition and death cause distribution in a respiratory intensive care unit,and provide reference for the diagnosis,treatment and prevention of severe respiratory diseases.Methods The data of the first page of the medical records of 1653 patients admitted to the respiratory intensive care unit of a Three a and Tertiary hospital in Shenyang from January 1 st,2017 to December 31 st,2019 were analyzed retrospectively.The main disease composition and death cause distribution of the patients in different gender and age groups were collected for statistical analysis.Results From 2017 to 2019,the top three diseases in respiratory intensive care unit were pneumonia(18.73%),pulmonary infection(14.51%)and pulmonary embolism(8.63%).The ratio of male to female was 1.19:1.The proportion of pulmonary infection(χ^2=6.533,P=0.011),acute exacerbation of COPD(χ^2=4.017,P=0.045)and aspiration pneumonia(χ^2=10.453,P=0.001)in men was higher than that in women.62.97%of the patients were aged 65 and over.The proportion of acute attack of chronic bronchitis and acute exacerbation of chronic obstructive pulmonary disease was higher in the group over 65 than in the group under 65.Pulmonary infection is the leading cause of death in respiratory intensive care unit.Conclusions Pneumonia,pulmonary infection and pulmonary embolism were the main diseases in the respiratory intensive care unit of a hospital,and the majority of the elderly patients over 65 years old.It was suggested that the relevant departments should strengthen the monitoring of pulmonary infection and its related risk factors,and improve the diagnosis and treatment level and rescue ability of severe respiratory diseases.