区域医疗中心咳嗽患者临床特征及就诊流向的大数据挖掘分析  

Big data mining analysis of the clinical characteristics and direction in seeking medical service of cough patients in regional medical centres

作　　者：谢仁炜 王朝昕 李云霞 沈宇 何琳 石建伟 姜丽秋 石宝平 肖洁汶 XIE Ren-wei;WANG Zhao-xin;LI Yun-xia;SHEN Yu;HE Lin;SHI Jian-wei;JIANG Li-qiu;SHI Bao-ping;XIAO Jie-wen(Science and Education Section Department of Shanghai Baoshan District Renhe Hospital,Shanghai 200431,China;不详)

机构地区：[1]上海市宝山区仁和医院科教科,上海200431 [2]上海交通大学公共卫生学院社会医学与卫生管理学系,上海200020 [3]上海市宝山区仁和医院院办 [4]上海市宝山区仁和医院信息科 [5]上海市宝山区仁和医院医务科 [6]上海市宝山区仁和医院呼吸内科 [7]上海市宝山区吴淞中心医院院办,上海200940

出　　处：《中华全科医学》2022年第12期2143-2146,共4页Chinese Journal of General Practice

基　　金：上海市浦江人才计划项目(2019PJC072);上海市卫生和计划生育委员会科研课题(20184Y0117);上海市宝山区科学技术委员会科技创新专项资金项目(19-E-10)。

摘　　要：目的分析区域医疗中心门诊有咳嗽症状患者的临床特征及就诊流向,了解其临床特点,为相关研究提供流行病学依据,同时为区域医疗中心优化咳嗽患者分诊提供参考。方法收集2017年1月1日—2019年12月31日上海市某区域医疗中心3年的门诊数据,分析其中有咳嗽症状患者的症状、主要诊断及就诊流向。结果该医疗中心3年共接诊有咳嗽症状的门诊患者110240人次,占总门诊量的5.85%,2017—2019年门诊有咳嗽症状的患者数量和占比均呈增长趋势。患者年龄为51.0(21.5,64.0)岁,女性57868人次(52.49%),男性52372人次(47.51%),女性占比高于男性(χ^(2)=274.002,P<0.001)。按咳嗽病程分类,急性咳嗽(时间<3周)103702人次(94.07%),亚急性咳嗽(时间3~8周)3343人次(3.03%),慢性咳嗽(时间>8周)3195人次(2.90%),不同咳嗽类型在不同年龄组、性别组中分布差异均有统计学意义(均P<0.05)。咳嗽患者伴随症状前3位分别为咳痰、发热和流涕,主要诊断前3位分别为呼吸道感染、急性咽炎和急性上呼吸道感染,此外,咳嗽伴随症状和主要诊断在不同咳嗽类型分组和不同年龄分组中的分布不同。咳嗽患者就诊流向较集中,主要为急诊内科、儿科和呼吸内科。结论门诊就诊患者中有咳嗽症状的数量呈增长趋势,各类型咳嗽在不同人群分组中分布存在差异。Objective To analyse the clinical characteristics and direction in seeking medical service of patients with cough symptoms in regional medical centres,understand the clinical characteristics of cough patients,provide epidemiological basis for related clinical research,and offer a reference for regional medical centres to optimise the triage of cough patients.Methods This study collected three-year outpatient data of a regional medical centre in Shanghai from January 1,2017 to December 31,2019 and analysed the symptoms,main diagnosis and direction in seeking medical service of patients with cough symptoms.Results A total of 110240 outpatients with cough symptoms were received from 2017 to 2019,accounting for 5.85%of the total outpatients.The number and proportion of outpatients with cough symptoms showed an increasing trend.The average age of patients was 51.0(21.5,64.0)years old,with 57868 female(52.49%)and 52372 male(47.51%)patients.The proportion of female patients was higher than that of male(χ^(2)=274.002,P<0.001).According to the classification of cough duration,94.07%(103702)had acute cough(cough time<3 weeks),3.03%(3343)had subacute cough(cough time 3-8 weeks),and 2.90%(3195)had chronic cough(cough time>8 weeks).The distributions of different types of coughs in age and gender groups differed(all P<0.05).The top three associated symptoms of cough patients were expectoration,fever and runny nose.The top three main diagnoses were respiratory tract infection,acute pharyngitis and acute upper respiratory tract infection.The distributions of cough associated symptoms and main diagnosis in different cough types and different age groups were different.In addition,the main departments receiving patients with cough were Emergency Department,Paediatrics and Respiratory Medicine.Conclusion The number of outpatients with cough symptoms shows an increasing trend,and the distributions of different types of coughs in the population group is different.

关 键 词：门诊 咳嗽 临床特征 就诊流向 大数据 

分 类 号：R441.5[医药卫生—诊断学] R197.323.1[医药卫生—临床医学]