摘要
背景 静脉血栓栓塞症(VTE)已成为继缺血性心脏病、脑卒中后位居第三的常见心血管疾病。自2018年“全国肺栓塞和深静脉血栓形成防治能力建设项目”正式启动以来,医务人员对VTE重视程度提高,VTE筛查率也明显增加。然而,VTE相关的流行病学调查多局限于单中心研究,仍然缺乏大规模,包含不同级别、不同性质医疗机构的VTE患病率调查数据。目的 了解嘉兴市VTE的患病率和流行病学特征,为进一步做好本地区VTE防治工作提供依据。方法 纳入2021年嘉兴市所有二级及以上医疗机构731 755例出院诊断为VTE的患者为研究对象,收集患者一般资料和反映医院收治患者数量与诊疗技术难度的疾病诊断相关分组指标。采用多元线性回归分析探究医院VTE患者数量的影响因素。结果 依据纳入、排除标准,VTE患者共计10 758例,患者中位年龄71(62,79)岁。综合性医院VTE患者例数最多,达到9 732例(90.46%),精神专科医院例数最少,为53例(0.49%)。三级医院VTE患者例数高于二级医院[7 929例(73.70%)比2 829例(26.30%)]。综合性医院VTE患者占出院人次比例最高,为1.85%,妇幼保健院最低,为0.10%;三级医院VTE患者占出院人次比例高于二级医院,分别为1.80%、0.97%。不同年龄组VTE患病率比较,差异有统计学意义(χ^(2)=32 383.098,P<0.001)。不同年龄组两两间比较,高年龄组VTE患病率均高于低年龄组(P<0.05)。15~44岁男性VTE患病率明显高于女性(P<0.001)。手术治疗是VTE患者危险因素分布排名第1位的危险因素,其次为伴有恶性肿瘤。多元线性回归分析结果显示,权重(RW)≥2例数是VTE患者数量的影响因素(P<0.001),RW≥2例数每增加1例,VTE例数增加0.363例。结论 嘉兴市VTE患病率为199.2/10万,疾病负担已经达到甚至超过西方国家。VTE发生的重点风险人群为行手术治疗、伴有恶性肿瘤等合并症的高龄患者。应进一步提高本地区综合性医院VTE防治水平,并且提升中医医院、妇幼保健院、精神专科医院对VTE规范化防治的参与度与重视程度。
Background Venous thromboembolism(VTE)has become the third most common cardiovascular disease after ischemic heart disease and stroke.Since the official launch of the National Programme for Prevention and Management of Pulmonary Embolism and Deep Vein Thrombosis in 2018,medical personnel have paid more attention to VTE,and the screening rate of VTE has also increased significantly.However,epidemiological investigations related to VTE are mostly limited to single center studies.There is still a lack of large-scale survey data on the prevalence of VTE involving different levels and properties of medical institutions.Objective To understand the prevalence and epidemiological characteristics of VTE in Jiaxing,and provide a basis for further prevention and treatment of VTE in this region.Methods A total of 731755 discharged patients diagnosed with VTE from all secondary and above medical institutions in Jiaxing City in 2021 were included as the study subjects.General patient data and disease diagnosis-related grouping indicators reflecting the number of patients admitted to the hospital and the difficulty of diagnosis and treatment techniques were collected.Multiple linear regression analysis was used to explore influencing factors of the number of VTE patients in hospitals.Results According to inclusion and exclusion criteria,a total of 10758 VTE patients were diagnosed.The median age of patients was 71(62,79)years.The number of VTE patients in general hospital was the highest,which amounting to 9732 cases(90.46%),while the number of VTE patients in psychiatric hospital was the lowest at 53 cases(0.49%).The number of VTE patients in tertiary hospitals was higher than that in secondary hospitals[7929(73.70%)vs.2829(26.30%)].The proportion of VTE patients in general hospital was the highest at 1.85%,and the lowest in maternal and child health hospital at 0.10%.The proportion of VTE patients in tertiary hospitals was higher than that in secondary hospitals,at 1.80%and 0.97%,respectively.The prevalence of VTE in different age groups was statistically significant(χ^(2)=32383.098,P<0.001).The prevalence of VTE in the high age group was higher than that in the low age group(P<0.05)when comparing the prevalence of VTE between different age groups(P<0.05).The prevalence of VTE in males aged 15-44 years was significantly higher than that in females,with statistical significant difference(P<0.001).Surgical treatment was the first risk factor in the distribution of VTE patients,followed by the presence of malignant tumors.The results of linear regression analysis showed that weight(RW)≥2 cases was the factor influencing the number of VTE patients(P<0.001),and the number of VTE cases increased by 0.363 for each increase in the number of cases with RW≥2 cases.Conclusion The prevalence rate of VTE in Jiaxing is 199.2 per 100000 population,and the disease burden of VTE in Jiaxing has reached or even exceeded western countries.The main risk populations of VTE were elderly patients who have received surgical treatment,with malignant neoplasm,etc.The level of prevention and treatment of VTE in general hospitals in this region should be further improved.In addition,the participation and attention to the standardized prevention and treatment of VTE in traditional Chinese medicine hospitals,maternity and child health care hospitals and psychiatric hospitals should be enhanced.
作者
洪玲
陆李萍
程宁
孙琴
江建红
朱良枫
HONG Ling;LU Liping;CHENG Ning;SUN Qin;JIANG Jianhong;ZHU Liangfeng(Department of Quality Management,the First Hospital of Jiaxing,Jiaxing 314000,China;Medical Administration Department,Jiaxing Municipal Heath Commission,Jiaxing 314000,China;Information Office,Jiaxing Municipal Heath Commission,Jiaxing 314000,China)
出处
《中国全科医学》
CAS
北大核心
2024年第15期1837-1842,共6页
Chinese General Practice
基金
国家临床重点专科建设项目(肿瘤科)(2023-GJZK-001)
嘉兴市第一医院/嘉兴学院附属医院联合科研基金(2022LHJJ005)
嘉兴市研究型医院学会科研基金项目(2021JYHA002)。
