【摘要】 目的:了解北京市三级综合性医院肠道门诊就诊患者疾病谱和流行病学特征,重点分析肠道传染病在不同人群中的分布,探索针对重点人群的肠道传染病防治策略。方法:利用国家高技术研究发展计划("863"计划)资助项目在北京市朝阳区和海淀区2所三级综合性医院(A医院和B医院)设立的腹泻症状监测系统,收集2009年4月1日至10月31日所有就诊患者的病历数据,运用描述性流行病学研究方法对就诊患者的疾病种类和流行病学特征进行分析,描述感染性腹泻占腹泻病的比例,分析不同月份、不同年龄和不同职业人群感染性腹泻比例的变化情况。结果:北京市2所三级综合性医院肠道门诊就诊患者患腹泻病的种类主要有10种,以非传染病占总体比例最高(77.4%),传染病比例最小(8.7%),各种疾病中胃肠炎及肠炎的病例最多,共7565例,占70.2%;就诊人数以夏秋季最多(7～10月),该期间就诊人数为(60.78±16.85)例/日,就诊人数总体存在明显季节性变化,以7和8月占总体比例最大(占41.82%),其他感染性腹泻患者在5月占当月就诊人数比例最高(5.3%),在10月最低(1.1%),细菌性痢疾患者在9月占当月就诊人数比例最高(8.2%),在4月最低(3.8%);就诊患者户籍主要为本市(61.9%),以中青年群体为主(73.9%),职业主要为学生(28.8%);腹泻病在不同年龄中的分布相似,但在不同职业中的分布不尽相同,传染病在18～44岁组中比例(9.2%)以及在餐饮食品从业人员中比例(15.2%)为高。结论:北京市2所三级综合性医院肠道门诊就诊人数以7和8月份最多,就诊疾病主要以非传染病为主,感染性腹泻占一定比例;就诊患者以户籍为本市、中青年人和学生为主。提示夏秋季是肠道传染病的重点防控时间,应将本市的中青年人和学生群体作为肠道传染病防控的重点人群,且应加强肠道门诊的建设,延长开诊时间,做好肠道传染病疫情控制工作。更多还原

【Abstract】 Objective:To understand the spectrum of diseases and epidemiological characteristics of outpatients at Entric Disease Clinic,with a focus on analysis of the distribution of infectious diarrheal diseases in different populations and to explore disease control strategies on Enteric Infectious Diseases for focal groups.Methods:A census on outpatients at Entric Disease Clinics was conducted in two class Three comprehensive hospitals in Beijing from April 1 to October 31,2009 based on a descriptive study using diarrhea-syndrome surveillance system set in the two clinics,thus to depict the spectrum of diseases and epidemiological characteristics of outpatients,and analyze the proportion of infectious diarrhea in diarrheal diseases specifically and the rate changes of infectious diarrhea in different months,age groups and occupational groups.Results:Diseases are varied at the two enteric diseases clinics among the patients and there are mainly 10 kinds of diseases,"non-infectious diarrhea" accounted for the highest percentage(77.4%),followed by "unspecified diarrhea"(11.7%),and infectious diarrhea accounted for the least proportion(8.7%)."Gastroenteritis and enteritis" are the most frequently diagnosed cases among all the diseases,was a total of 7 565 cases,accounting for 70.2%.The volume of visits reached its top during summer and autumn(July to September),and the mean volume of visits in this period is(60.78±16.85)cases/day.The volume of visits has an obvious seasonal trend,and visits during July and August are the most frequent(41.82% altogether).Patients with "infectious diarrhea" had a highest ratio(5.3%)in May and lowest(1.1%)in October while patients with "bacillary dysentery" accounted for a highest ratio(8.2%)in September and lowest(3.8%)in April.Outpatients are mainly from Beijing city(61.9%),in which young and middle-aged people accounted for 73.9% in total,and student is the main occupation(28.8%).The distributions of diarrheal diseases are the same in different age groups but differ from different occupational groups.Infectious diarrhea accounted for a highest proportion(9.2%)in 18-to-44-year-old age group when using age grouping,and a highest proportion(15.2%)in restaurant service personnel when using occupation grouping.Conclusion:The volume of outpatients attended at general hospitals is overwhelming especially in July and August,and the major type is "non-infectious diseases",which indicates an arduous task on prevention and control of Enteric Infectious Diseases.Infectious diarrhea took up a certain amount,but the rate is not that high,which indicates possible missing diagnosis of patients with infectious diseases.Our focal groups would be young and middle-aged people and students in the city.Therefore,the need to extend the consultation hours is urgent.Meanwhile,for the main goal of surveillance and early warning on Enteric Infectious Diseases,all aspects of construction of Enteric Disease Clinic should be strengthened,such as enhance laboratory tests on pathogens,improve diagnosis level of physicians and etc.更多还原