上海市某社区5岁以下儿童肺炎发病与诊疗情况分析  

Retrospective study on incidence and diagnosis of pneumonia in children under 5 years old in a community of Shanghai

作　　者：王婧[1] 黄卓英[2] 胡家瑜[2] 姜铭波[1] 陆瑾[1] 许振慧[1] 孙晓冬[2] WANG Jing1, HUANG Zhuo-ying2, HU Jia-yu2, JIANG Ming-bo1, LU Jin1, XUZhen-hui1, SUN Xiao-dong2(1. Huangpu District Center for Disease Control and Prevention, Shanghai200023, China;2. Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336,Chin)

机构地区：[1]上海市黄浦区疾病预防控制中心,上海200023 [2]上海市疾病预防控制中心,上海200336

出　　处：《上海预防医学》2018年第7期552-556,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市疾病预防控制中心项目(2012zx100004703-010)

摘　　要：【目的】了解儿童肺炎的流行特征、疾病负担及肺炎疫苗接种情况。【方法】对上海市某社区2012年1月1日—12月31日期间诊断为肺炎的5岁以下儿童进行回顾性调查,获得病例的流行病学和诊疗费用信息,并进行统计分析。【结果】共调查了5岁以下儿童1 079人,确诊肺炎86例,儿童肺炎发病率为7.97%,其中男性发病率为9.63%,女性发病率为5.95%。2~岁组发病率最高(11.70%);春季和冬季高发。23例在肺炎发病前有肺炎疫苗接种史(占26.74%);住院病例16例(占18.60%),发病前有肺炎疫苗接种史的病例住院比例(4.35%)明显低于无肺炎疫苗接种史的病例(23.81%),差异有统计学意义(P<0.05)。86例肺炎病例产生的总费用为345 444元,平均每个病例花费4 017元,其中陪护费最高,占57.03%,其次是门诊就诊费和住院费,分别占22.13%和9.92%。对费用有影响的因素为是否住院治疗,住院病例的花费高于未住院病例(P<0.05)。【结论】5岁以下儿童肺炎病例的高住院率与未接种肺炎疫苗有关;降低住院率将减少儿童肺炎疾病负担;儿童肺炎疫苗接种能减少儿童肺炎的发生和住院。[Objective]To obtain data on epidemics characteristics, disease burden and pneumonia vaccination for children pneumonia. [Methods] A retrospective study was conducted on children under 5 who had been diagnosed with pneumonia from Jan 1 to Dec 31 in 2012. The information thus obtained on epidemiology and cost of medical service was statistically analyzed. [Results] A total of 1 079 children under 5 were investigated,of whom 86 were diagnosed with pneumonia in 2012. The incidence rate of pneumonia in children was 7. 97%; the incidence of male was 9. 63% and that of female was 5. 95%,with the highest incidence rate（ 11. 70%） in those aged 2 to 3 years in all age groups. Incidence rate was found to be higher in spring and winter. Twenty-three people（ 26. 74%） had a history of pneumonia vaccination before the onset of pneumonia. The number of hospitalized cases was 16（ 18. 60%）. Those with a history of pneumonia vaccination before onset had an obviously lower hospitalized proportion（ 4. 35%） than those without（ 23. 81%）,and the difference between them was statistically significant（ P 0. 05）. The total cost for the 86 cases was 345 444 yuan,and 4 017 yuan for each on average. The medical nursing cost was the highest, accounting for 57. 03%. The outpatient cost and hospitalization cost were 22. 13% and9. 92%. The factor affecting the amount of cost was hospitalization,and the costs for hospitalization was higher than those for non-hospitalized cases（ P〈0. 05）. [Conclusion] The high hospitalization rate for children under 5 is associated with no pneumonia vaccination. Reducing hospitalization rates will effectively reduce the burden of childhood pneumonia. Vaccination for children can effectively reduce the occurrence and hospitalization rate for children pneumonia.

关 键 词：儿童 肺炎 发病率 肺炎疫苗 经济负担 

分 类 号：R183.3[医药卫生—流行病学]