论著

天津市某眼科医院急诊病例疾病谱分析

Epidemiological analysis of emergency ophthalmic cases in a specialist hospital in Tianjin

:416-428
 
目的:分析天津市某眼科医院急诊病例疾病谱,为规范疾病诊断流程、合理分配急诊医疗资源提供循证依据。方法 回顾性分析2019年1月~2023年12月在天津市某眼科医院急诊科就诊患者的临床资料,包括一般人口学资料、就诊时间、季节分布及初步诊断等。结果:共纳入26 077例眼科急诊患者,男女比例为1.12∶1,年龄为(36.82±15.44)岁,就诊年龄大多分布在<14岁(26.74%)及31~40岁(21.03%);日就诊时间分布中:10:00~12:00(11.06%)、14:00~16:00(10.41%)及20:00~22:00(10.43%)就诊人数较多,05:00~07:00(4.83%)就诊人数较少;4月就诊人数最少(3.87%),8月就诊人数最多(11.61%),夏季就诊人数(31.74%)显著多于其他3个季节;眼科急诊患者最常见的10种初步诊断中结膜炎占比最多(39.58%),其次为干眼症(14.32%);与2019年相比,2020年和2021年眼科急诊患者前10种初步诊断显著下降(均P<0.001,2020年95%CI为-0.98~-0.68、2021年95%CI为-0.54~-0.11);与春季相比,其他季节眼科急诊患者前10种初步诊断显著下降(P均<0.001,夏季95%CI为-0.32~-0.08、秋季95%CI为-0.39~-0.14、冬季95%CI为-0.54~-0.30)。其中在结膜炎病例中,与春、夏季相比,冬季结膜炎病例分布呈显著下降趋势(P均<0.001,95%CI分别为-0.08~-0.03]、为-0.08~-0.04);眼科急诊患者前10种初步诊断性别分布具有统计学意义(P<0.001);与14岁以下年龄段相比,其他年龄眼科急诊患者前10种初步诊断均呈下降趋势,(P均<0.001,14~20岁95%CI为-0.88~-0.43、21~30岁95%CI为-1.01~-0.65、31~40岁95%CI为-1.10~-0.82、41~50岁95%CI为-0.97~-0.66、51~60岁95%CI为-1.71~-1.38、61~70岁95%CI为-1.45~-1.08、71~80岁95%CI为-1.36~-0.80、>80岁95%CI为-1.44,-0.22)。结论:眼科急诊患者以儿童和中青年男性为主,14岁以下年龄段人群相比来说有较高风险;日就诊时间分布呈现出“三个高峰一个低谷”的显著特征,就诊高峰时段分别为10:00~12:00、14:00~16:00以及20:00~22:00,就诊低谷出现在05:00~07:00期间;眼科急诊中最常见的诊断主要是那些通常被认为是非紧急的诊断,即结膜炎和干眼症;结膜炎的发病呈现明显的季节性特征,春、夏季为高发期;与2019年相比,2020年和2021年眼科急诊就诊总量显著减少,其中以结膜炎和干眼症的就诊量减少尤为明显,2022年有一定程度的恢复。
Purpose:To analyze the disease spectrum of emergency cases at an ophthalmology hospital in Tianjin, offering evidence-based support for standardizing diagnostic procedures and rationing emergency medical resources. Methods: Reviewed clinical data of patients at the hospital's emergency department from January 2019 to December 2023, covering demographics, visit timings, seasonal distribution, and preliminary diagnoses. Results: A total of 26,077 ophthalmology emergency patients were included, with a male-to-female ratio of 1.12:1 and an average age of 36.82±15.44 years. Most patients were aged <14 years (26.74%) and 31~40 years (21.03%). Daily visits peaked at 10:00~12:00 (11.06%), 14:00~16:00 (10.41%), and 20:00~22:00 (10.43%), and were lowest at 05:00~07:00 (4.83%). April had the fewest visits (3.87%), August the most (11.61%), and summer accounted for the highest quarterly proportion (31.74%). The top 10 preliminary diagnoses were led by conjunctivitis (39.58%) and xerophthalmia (14.32%). Compared to 2019, the top 10 preliminary diagnoses dropped significantly in 2020 and 2021 (both P<0.001), 2020 95%CI[-0.98~-0.68]、2021 95%CI[-0.54~-0.11]. Similarly, these diagnoses were significantly lower in summer, autumn, and winter than in spring (all P<0.001), summer 95%CI[-0.32~-0.08]、autumn 95%CI[-0.39~-0.14]、winter 95%CI[-0.54~-0.30]. In conjunctivitis cases, winter incidence was significantly lower than in spring and summer (both P<0.001). Gender distribution in the top 10 diagnoses was statistically significant (P<0.001), 95%CI[-0.08~-0.03] and [-0.08~-0.04] . Compared to those aged <14, other age groups showed a downward trend in the top 10 preliminary diagnoses (all P<0.001), 14~20 95%CI[-0.88~-0.43]、21~30 95%CI[-1.01~-0.65]、31~40 95%CI[-1.10~-0.82]、41~50 95%CI[-0.97~-0.66]、51~60 95%CI[1.71~-1.38]、61~70 95%CI[-1.45~-1.08]、71~80 95%CI[-1.36~-0.80]、>80 95%CI[-1.44,-0.22].Conclusions: Ophthalmology emergency patients are mainly children and middle-aged men, with those <14 years old at higher risk. Visit times follow a "three-peak-one-valley" pattern. Most diagnoses are non-urgent conditions like conjunctivitis and xerophthalmia. Conjunctivitis shows marked seasonality, peaking in spring and summer. Total ophthalmology emergency visits declined in 2020 and 2021 versus 2019, particularly for conjunctivitis and xerophthalmia, partially recovering in 2022.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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