目的:研究急诊留观患者的疾病谱及流行病学特征.方法:回顾分析2005年1月1日-2009年12月31日在山西医科大学第二医院急诊科就诊且具有完整病史记载的20331例留观患者的临床资料,按国际疾病分类标准第10版( international statistical classification of diseases,injuries and causes of death,10th revision,ICD-10)进行疾病分类,并对患者年龄、性别、病种、就诊时间等进行统计.结果:(1)急诊留观患者的前6大病种依次是:外伤中毒和其他外因所造成的特定影响、循环系统疾病、消化系统疾病、呼吸系统疾病、神经系统疾病及血液和造血器官及涉及免疫机制的疾患,其中前2大病种占前6大病种的51.33％.(2)循环系统疾病的患者就诊年龄最大,为(61.20±15.91)岁；精神和行为障碍患者的就诊年龄最小,为(32.34±11.32)岁；(3)男女性别构成比在各大病种中存在显著差异(P＜0.001)；(4)日就诊时间主要集中于16:00～24:00,该时间段就诊的患者人数占每日患者总人数的42.57％,就诊高峰点为22:00左右；(5)前6大病种就诊时期呈季节性特点.(6)急诊前10位的诊断或主诉依次是损伤、冠心病、内科腹痛、外科腹痛、脑血管疾病、急性中毒、上呼吸道感染、头晕或头痛、心衰和心律失常以及贫血,占全部患者的67.38％.其中损伤占16.50％、腹痛(包括内科和外科腹痛)占14.66％、冠心病占9.98％.结论:应根据急诊留观患者的疾病谱及流行病学特点,合理安排急诊资源,确立学科建设重点和人才培养方向,以适应新形势下急诊发展和管理的需要.%Objective:This study aims to investigate the disease spectrum and the epidemiological characteristics of emergency patients staying in the observation room. Methods: A tatol of 20 331 well-documented emergency patients from January 1st, 2005 to December 31th, 2009 were enrolled. The types of diseases were classified by international statistical classification of diseases, injuries and causes of death, 10th revision (ICD-10). The age, sex, disease type, visiting time of the patients have been statistically analyzed. Results: (1) The top six diseases from which the emergency patients who had to stay in the observation room suffered were injuries and poisoning and certain other consequences of external causes, circulatory system diseases, digestive system diseases, respiratory system diseases, nervous system diseases, and diseases of hematopoietic organs and blood; these 6 types accounted for 85. 91% of the total while the former two types accounted for 51. 33% of the 6 categories. (2) The average age of the patients with circulatory diseases was the largest ￡(61. 20 ± 15. 91) years old] , while that of the patients with mental and behavioral disorders was the smallest [(32. 34 ± 11. 32) years old] . (3) The constituent ratio of sex differed in disease distribution. (4) Daily clinical time focused on 16 : 00—24 : 00. The number of patients visiting emergency room during that period accounted for 42. 57% of the total, and the peak point was at 22 : 00 around. (5) The top six diseases had seasonal distribution characteristics (6) The first tenth emergency diagnosis or complaints were injuries, coronary heart diseases, medical abdominal pain, surgical abdominal pain, cerebrovascular diseases, acute poisoning, upper respiratory tract infection, dizziness or headache, heart failure and arrhythmias and anemia, which accounted for 67. 38% of all kinds of diseases. Among them, injuries, medical and surgical abdominal pain and coronary heart diseases accounted for 16. 50% , 14. 66% and 9. 98%, respectively. Conclusions: Emergency resources should be arranged reasonably and discipline should be established, according to the spectrum and epidemiological characteristics of diseases, from which patients in emergency observation room suffered.
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