目的 调查我国大中城市院前急救患者流行病学情况,探讨院前急救病例特点.方法 从我国8个大中城市急救中心系统数据库中导出2008年度全部数据,就其有完整记录的资料进行统计分析.结果 (1)院前急救组调度时间、到达时间、现场时间、返回时间、出车总时间、急救半径分别为(2.16±1.10)min,(14.01±6.82)min,(12.12±5.96)min,(14.08±6.85)min,(42.34±20.21)min和(8.50±4.18)km,院前非死亡组分别为(2.19±1.13)min,(14.15±7.14)min,(11.60±6.72)min,(14.92±6.89)min,(41.86±19.53)min和(8.63±4.31)km,院前死亡组分别为(2.10±1.08)min,(13.68±7.14)min,(25.25±12.34)min,(13.75±6.48)min,(54.74±25.47)min和(7.86±3.91)km,院前非心脏性猝死组分别为(2.09±1.03)min,(13.58±6.78)min,(25.53±12.34)min,(13.60±6.54)min,(53.79±23.77)min和(7.67±3.86)km,院前心脏性猝死组分别为(2.12±1.02)min,(14.10±7.05)min,(24.79±12.08)min,(13.79±6.61)min,(54.80±25.36)min和(7.90±3.92)km.院前死亡组的调度时间、到达时间、返回时间、急救半径均明显小于院前非死亡组,前组的现场时间、出车总时间均明显大于后者(P＜0.05或P＜0.01).院前心脏性猝死组的调度时间、返回时间与院前非心脏性猝死组的差异无统计学意义(P＞0.05),但前组的到达时间、出车总时间、急救半径均明显大于后组,而现场时间明显小于后组(P＜0.05或P＜0.01).(2)院前急救组、院前非死亡组、院前死亡组、院前非心脏性猝死组、院前心脏性猝死组的病例数均以第一季度为最多,其最少时间段分别是4:00-6:00、4:00-6:00、4:00-6:00、22:00-24:00、2:00-4:00,其最多时间段分别是20:00-22:00、20:00-22:00、8:00-10:00、2:00-4:00、8:00-10:00.(3)在241 876例院前急救病例中,创伤类患者是院前急救中最多的,年龄以21～50岁青壮年最多;其余依次是神经系统、循环系统、其他、消化系统、呼吸系统、中毒类,且神经系统、循环系统、呼吸系统类均以51岁(尤其是70岁)以上的中老年最多;其他、消化系统类均有两个高峰年龄段,其一是21～30岁青年阶段,其二是70岁以上的老年;中毒类以21～50岁青壮年最多,其中急性酒精中毒是最常见的病因.(4)在12 568例院前死亡病例中,循环系统、其他、呼吸系统、神经系统、消化系统类的死亡分别居第一、二、四、五、八位,均以51岁(尤其是70岁)以上的中老年最多,其中心脏性猝死又是循环系统类的死亡中最多的;创伤、中毒类的死亡分别居第三、六位,均以21～50岁青壮年最多.(5)男性患者院前急救的数量、总死亡量及院前心脏性猝死均明显高于女性.(6)院前死亡患者占院前急救的5.20%,院前心脏性猝死占院前急救的1.29%,院前心脏性猝死占院前死亡的24.87%,院前心脏性猝死占循环系统类死亡的67.33%.结论 (1)创伤与心脏性猝死已分别成为我国大中城市最常见的院前急救和致死原因.(2)加强心脑血管病和呼吸系统疾病防治,提高中老年患者的常见急危重症早期识别与院前急救水平对降低死亡率有重要意义.(3)加强安全生产、遵守交通法规、强化法制意识将是降低创伤,尤其是交通意外伤发生及其死亡的有力于段.
目的 調查我國大中城市院前急救患者流行病學情況,探討院前急救病例特點.方法 從我國8箇大中城市急救中心繫統數據庫中導齣2008年度全部數據,就其有完整記錄的資料進行統計分析.結果 (1)院前急救組調度時間、到達時間、現場時間、返迴時間、齣車總時間、急救半徑分彆為(2.16±1.10)min,(14.01±6.82)min,(12.12±5.96)min,(14.08±6.85)min,(42.34±20.21)min和(8.50±4.18)km,院前非死亡組分彆為(2.19±1.13)min,(14.15±7.14)min,(11.60±6.72)min,(14.92±6.89)min,(41.86±19.53)min和(8.63±4.31)km,院前死亡組分彆為(2.10±1.08)min,(13.68±7.14)min,(25.25±12.34)min,(13.75±6.48)min,(54.74±25.47)min和(7.86±3.91)km,院前非心髒性猝死組分彆為(2.09±1.03)min,(13.58±6.78)min,(25.53±12.34)min,(13.60±6.54)min,(53.79±23.77)min和(7.67±3.86)km,院前心髒性猝死組分彆為(2.12±1.02)min,(14.10±7.05)min,(24.79±12.08)min,(13.79±6.61)min,(54.80±25.36)min和(7.90±3.92)km.院前死亡組的調度時間、到達時間、返迴時間、急救半徑均明顯小于院前非死亡組,前組的現場時間、齣車總時間均明顯大于後者(P＜0.05或P＜0.01).院前心髒性猝死組的調度時間、返迴時間與院前非心髒性猝死組的差異無統計學意義(P＞0.05),但前組的到達時間、齣車總時間、急救半徑均明顯大于後組,而現場時間明顯小于後組(P＜0.05或P＜0.01).(2)院前急救組、院前非死亡組、院前死亡組、院前非心髒性猝死組、院前心髒性猝死組的病例數均以第一季度為最多,其最少時間段分彆是4:00-6:00、4:00-6:00、4:00-6:00、22:00-24:00、2:00-4:00,其最多時間段分彆是20:00-22:00、20:00-22:00、8:00-10:00、2:00-4:00、8:00-10:00.(3)在241 876例院前急救病例中,創傷類患者是院前急救中最多的,年齡以21～50歲青壯年最多;其餘依次是神經繫統、循環繫統、其他、消化繫統、呼吸繫統、中毒類,且神經繫統、循環繫統、呼吸繫統類均以51歲(尤其是70歲)以上的中老年最多;其他、消化繫統類均有兩箇高峰年齡段,其一是21～30歲青年階段,其二是70歲以上的老年;中毒類以21～50歲青壯年最多,其中急性酒精中毒是最常見的病因.(4)在12 568例院前死亡病例中,循環繫統、其他、呼吸繫統、神經繫統、消化繫統類的死亡分彆居第一、二、四、五、八位,均以51歲(尤其是70歲)以上的中老年最多,其中心髒性猝死又是循環繫統類的死亡中最多的;創傷、中毒類的死亡分彆居第三、六位,均以21～50歲青壯年最多.(5)男性患者院前急救的數量、總死亡量及院前心髒性猝死均明顯高于女性.(6)院前死亡患者佔院前急救的5.20%,院前心髒性猝死佔院前急救的1.29%,院前心髒性猝死佔院前死亡的24.87%,院前心髒性猝死佔循環繫統類死亡的67.33%.結論 (1)創傷與心髒性猝死已分彆成為我國大中城市最常見的院前急救和緻死原因.(2)加彊心腦血管病和呼吸繫統疾病防治,提高中老年患者的常見急危重癥早期識彆與院前急救水平對降低死亡率有重要意義.(3)加彊安全生產、遵守交通法規、彊化法製意識將是降低創傷,尤其是交通意外傷髮生及其死亡的有力于段.
목적 조사아국대중성시원전급구환자류행병학정황,탐토원전급구병례특점.방법 종아국8개대중성시급구중심계통수거고중도출2008년도전부수거,취기유완정기록적자료진행통계분석.결과 (1)원전급구조조도시간、도체시간、현장시간、반회시간、출차총시간、급구반경분별위(2.16±1.10)min,(14.01±6.82)min,(12.12±5.96)min,(14.08±6.85)min,(42.34±20.21)min화(8.50±4.18)km,원전비사망조분별위(2.19±1.13)min,(14.15±7.14)min,(11.60±6.72)min,(14.92±6.89)min,(41.86±19.53)min화(8.63±4.31)km,원전사망조분별위(2.10±1.08)min,(13.68±7.14)min,(25.25±12.34)min,(13.75±6.48)min,(54.74±25.47)min화(7.86±3.91)km,원전비심장성졸사조분별위(2.09±1.03)min,(13.58±6.78)min,(25.53±12.34)min,(13.60±6.54)min,(53.79±23.77)min화(7.67±3.86)km,원전심장성졸사조분별위(2.12±1.02)min,(14.10±7.05)min,(24.79±12.08)min,(13.79±6.61)min,(54.80±25.36)min화(7.90±3.92)km.원전사망조적조도시간、도체시간、반회시간、급구반경균명현소우원전비사망조,전조적현장시간、출차총시간균명현대우후자(P＜0.05혹P＜0.01).원전심장성졸사조적조도시간、반회시간여원전비심장성졸사조적차이무통계학의의(P＞0.05),단전조적도체시간、출차총시간、급구반경균명현대우후조,이현장시간명현소우후조(P＜0.05혹P＜0.01).(2)원전급구조、원전비사망조、원전사망조、원전비심장성졸사조、원전심장성졸사조적병례수균이제일계도위최다,기최소시간단분별시4:00-6:00、4:00-6:00、4:00-6:00、22:00-24:00、2:00-4:00,기최다시간단분별시20:00-22:00、20:00-22:00、8:00-10:00、2:00-4:00、8:00-10:00.(3)재241 876례원전급구병례중,창상류환자시원전급구중최다적,년령이21～50세청장년최다;기여의차시신경계통、순배계통、기타、소화계통、호흡계통、중독류,차신경계통、순배계통、호흡계통류균이51세(우기시70세)이상적중노년최다;기타、소화계통류균유량개고봉년령단,기일시21～30세청년계단,기이시70세이상적노년;중독류이21～50세청장년최다,기중급성주정중독시최상견적병인.(4)재12 568례원전사망병례중,순배계통、기타、호흡계통、신경계통、소화계통류적사망분별거제일、이、사、오、팔위,균이51세(우기시70세)이상적중노년최다,기중심장성졸사우시순배계통류적사망중최다적;창상、중독류적사망분별거제삼、육위,균이21～50세청장년최다.(5)남성환자원전급구적수량、총사망량급원전심장성졸사균명현고우녀성.(6)원전사망환자점원전급구적5.20%,원전심장성졸사점원전급구적1.29%,원전심장성졸사점원전사망적24.87%,원전심장성졸사점순배계통류사망적67.33%.결론 (1)창상여심장성졸사이분별성위아국대중성시최상견적원전급구화치사원인.(2)가강심뇌혈관병화호흡계통질병방치,제고중노년환자적상견급위중증조기식별여원전급구수평대강저사망솔유중요의의.(3)가강안전생산、준수교통법규、강화법제의식장시강저창상,우기시교통의외상발생급기사망적유력우단.
Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.
