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目的分析和评估高温热浪与健康风险早期预警系统在南京市的试运行情况。方法分析2013年7月15日至9月30日预警模型发出的预警信号数,比较预警信号与试点医院同期门急诊、住院病例的相关性,以中暑病例评估模型的灵敏度和错误预警率。结果观察期间共发出预警信号170条,平均每日2.18条,心脑血管疾病、呼吸系统疾病、儿童呼吸系统疾病、中暑、总健康风险各占信号总数的22.9%(39/170),17.6%(30/170),18.8%(32/170),17.6%(30/170),22.9%(39/170)。不同预警级别的儿童呼吸系统疾病门急诊和住院病例数差异均有统计学意义(P<0.05),I级和II级预警的就诊数均高于0级(P<0.05或P<0.01);不同预警级别的呼吸系统和心脑血管疾病门急诊和住院病例差异均无统计学意义(P>0.05)。各项健康风险预警与当日气象高温预警均呈正相关(rs值为0.650~0.724,P<0.01)。中暑预警灵敏度为72.7%(8/11),中暑错误预警率为34.9%(22/63)。结论预警系统信号发出及时,运行状况良好,对儿童呼吸系统发病和中暑的预警准确率较高,但仍需进一步调整和完善。
Objective To analyze and evaluate the trial operation of high temperature heatwave and health risk early warning system in Nanjing. Methods The number of early warning signals from July 15, 2013 to September 30, 2013 was analyzed. The correlation between early warning signals and outpatients, emergency departments and hospitalized patients in the same period of the pilot hospital was compared. The sensitivities and false alarm rates of the model were evaluated with heat stroke patients. Results A total of 170 early warning signals were issued during the observation period, with an average of 2.18 days per day. Cardiovascular and cerebrovascular diseases, respiratory diseases, respiratory diseases, childhood heat stroke and total health risks accounted for 22.9% (39/170) of the total number of signals and 17.6% (30/170), 18.8% (32/170), 17.6% (30/170), 22.9% (39/170). There were significant differences in the numbers of emergency room and hospitalized children with respiratory disease at different warning levels (P <0.05). The number of first and second degree warning visits was higher than that of grade 0 (P <0.05 or P <0.01). There were no significant differences between the emergency department and hospitalized cases of respiratory system and cardiovascular and cerebrovascular diseases at different alert levels (P> 0.05). All health risk warnings were positively correlated with the meteorological high temperature warning on the same day (rs = 0.650-0.724, P <0.01). The sensitivity of heat stroke early warning was 72.7% (8/11), and the false alarm rate of heat stroke was 34.9% (22/63). Conclusion Early warning system signals are issued in good time and in good working order, and the warning rate of respiratory system onset and heat stroke in children is high, but it needs further adjustment and improvement.