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目的比较我国西部地区3个试点乡院2008～2010年住院疾病构成情况,为进一步循证遴选基本卫生技术、基本药物提供基线数据。方法文献分析法以疾病谱、疾病构成、住院病种、住院疾病等为关键词,计算机检索CBM、CNKI、VIP、万方等数据库及中国卫生部等官方网站,并辅以手工检索相关期刊,查找2005～2010年我国西部地区试点乡镇卫生院所在省份相关资料,并应用Excel软件整理分析。结果①共纳入16篇文献。其中期刊文献15篇,硕士论文1篇,4篇分值在0～3.5分,9篇在3.5～6.75分,3篇在7分及以上。②我国东、中、西部乡院常见住院疾病不尽相同。上感、急慢性支气管炎、急慢性胃炎和阑尾炎在全国乡院均为常见住院疾病。肺炎、肺气肿、胆结石和胆囊炎、急慢性胃肠炎在西南和西北地区乡院为常见住院疾病。3个试点乡院前15位住院单病种涵盖西南、西北地区乡院常见住院疾病。③2008～2010年,西部3个试点乡院住院前15位单病种共35种,含慢性病20种,急性病15种。慢性病依次为慢支炎、慢性胃炎、高血压、腰颈椎病、胆结石或伴胆囊炎、冠心病、肺心病、泌尿系统结石、盆腔炎、椎基底动脉供血不足、关节炎、慢支炎急发、梅尼埃病、慢性阻塞性肺气肿、心肌供血不足、前列腺炎等;急性病依次为上感、肺部感染、骨折、浅表损伤、急性阑尾炎、急支炎、泌尿道感染、急性胃炎、急性胃肠炎、分娩与剖宫产、软组织损伤、急性荨麻疹等。④常见住院病种较集中且稳定,部分病种有地方差异性,且患者年龄及性别结构不尽相同。结论①我国东、中、西部乡院常见住院疾病不尽相同,应因地制宜地遴选基本卫生技术或药物。②西部3个试点乡院常见住院疾病代表性好,可作为西部乡院遴选基本卫生技术或基本药物的基线证据。③目前尚缺乏全国和地区性的乡院疾病谱统计、调查资料及循证研究,且现有研究的调查方法或数据统计口径不一、质量参差不齐。④建议国家和各省市开展并完善乡院疾病谱统计与分析工作,培训相关人员,完善信息系统建设。
Objective To compare the composition of inpatient diseases in three experimental townships in western China from 2008 to 2010 and provide baseline data for further evidence-based selection of essential health technologies and essential medicines. Methods Literature analysis method to the disease spectrum, disease composition, inpatient disease, hospitalized diseases as the key words, computer search CBM, CNKI, VIP, Wanfang database and the official website of China’s Ministry of Health, supplemented by manual retrieval of relevant periodicals, Find the relevant data of the provinces where the pilot township hospitals in the western region of China from 2005 to 2010 are located, and analyze them with Excel software. Results ① A total of 16 articles were included. Among them, there are 15 journal articles and 1 master’s thesis, 4 papers have a score of 0 ~ 3.5, 9 papers have a score of 3.5 ~ 6.75 and 3 papers have a score of 7 or above. ② China’s eastern, central and western township common hospital diseases vary. On the flu, acute and chronic bronchitis, acute and chronic gastritis and appendicitis are common hospital diseases in rural homes. Pneumonia, emphysema, gallstones and cholecystitis, acute and chronic gastroenteritis are common hospital diseases in homes in the southwestern and northwestern regions. The first 15 pilot hospitals in the three pilot hospitals cover common hospital diseases in homes in the southwest and northwest regions. ③ From 2008 to 2010, there were 35 single diseases in the three experimental rural homes in the western region, including 20 chronic diseases and 15 acute diseases. Chronic diseases followed by chronic myelitis, chronic gastritis, hypertension, lumbar cervical spondylosis, gallstones or cholecystitis, coronary heart disease, pulmonary heart disease, urinary tract stones, pelvic inflammatory disease, vertebrobasilar insufficiency, arthritis, chronic bronchitis Hair, Meniere’s disease, chronic obstructive pulmonary emphysema, myocardial insufficiency, prostatitis, etc .; acute disease in turn on the flu, lung infections, fractures, superficial lesions, acute appendicitis, acute mycoplasma, urinary tract infections, acute Gastritis, acute gastroenteritis, childbirth and cesarean section, soft tissue injury, acute urticaria and the like. ④ common inpatient disease is more concentrated and stable, some diseases have local differences, and the patient’s age and gender structure are not the same. Conclusion ① The common hospital diseases in the east, middle and west towns and villages in China are not the same. Basic health technologies or drugs should be selected according to local conditions. ② The three pilot rural homes in western China have good representativeness of common in-hospital diseases and can be used as the baseline evidence for the selection of basic health technologies or essential medicines in western township homes. (3) At present, there is still a lack of statistics on national and regional hospital beds, survey data and evidence-based research, and the existing research methods or data statistics vary in caliber and quality. ④ It is suggested that the state and provinces and municipalities should carry out and improve the statistics and analysis of disease spectrum in rural homes, train relevant personnel and improve the construction of information systems.