本文選題：急性胃腸炎　切入點(diǎn)：秋冬季　出處：《中國疾病預(yù)防控制中心》2017年碩士論文

【摘要】：目的:1.了解當(dāng)?shù)厍锒竟?jié)兒童急性胃腸炎流行現(xiàn)狀、病因特點(diǎn)、影響因素和診療行為。2.評價當(dāng)?shù)厍锒緝和毙晕改c炎的DALYs和經(jīng)濟(jì)負(fù)擔(dān),并分析不同年齡組和不同癥狀類型病例的流行現(xiàn)狀、發(fā)病情況、就診情況和疾病負(fù)擔(dān)差異。方法:1.通過文獻(xiàn)、統(tǒng)計年鑒、政府報告、官方統(tǒng)計等,收集當(dāng)?shù)?歲以下兒童總?cè)藬?shù)、5歲以下兒童各年齡段人數(shù)分布、當(dāng)?shù)厝司鵊DP等基礎(chǔ)信息。通過詢問醫(yī)生,填寫醫(yī)療機(jī)構(gòu)調(diào)查表,了解當(dāng)?shù)蒯t(yī)療機(jī)構(gòu)及相關(guān)診室兒童腹瀉病例基本資料和治療方式。隨機(jī)抽取的20個社區(qū)的所有5歲以下、常住兒童納為研究對象。2.于2016年12月在河南睢縣開展現(xiàn)場調(diào)查,采用統(tǒng)一調(diào)查表入戶調(diào)查。主要內(nèi)容包括家庭和個人基礎(chǔ)資料,3個月內(nèi)最近一次急性胃腸炎發(fā)病資料(發(fā)病癥狀、持續(xù)時間等),就診情況(就診率、住院率、就診醫(yī)院、住院天數(shù)等),行為習(xí)慣、應(yīng)對方式、治療措施,醫(yī)療費(fèi)用、非醫(yī)療費(fèi)用和誤工天數(shù),急性胃腸炎影響因素(其他疾病、衛(wèi)生習(xí)慣、人文因素、信息途徑等)。3.使用EpiData3.1建立數(shù)據(jù)庫,資料復(fù)核并邏輯檢查。使用Excel2013和SPSS20.0進(jìn)行數(shù)據(jù)整理及分析,對調(diào)查人群基本特征、急性胃腸炎流行特征、就診行為與特點(diǎn)、經(jīng)濟(jì)負(fù)擔(dān)等進(jìn)行描述性分析,對相關(guān)影響因素進(jìn)行卡方檢驗(yàn)、方差分析、秩和檢驗(yàn)等,檢驗(yàn)水準(zhǔn)為0.05。采用兩周罹患率、傷殘調(diào)整壽命年(DALY)、直接經(jīng)濟(jì)負(fù)擔(dān)、間接經(jīng)濟(jì)負(fù)擔(dān)等指標(biāo)反映急性胃腸炎疾病負(fù)擔(dān)。結(jié)果:1.本次調(diào)查有效調(diào)查對象1582名,疾病負(fù)擔(dān)資料是260名對象的,3個月內(nèi)最近一次急性胃腸炎發(fā)病和就診情況。兩周內(nèi)急性胃腸炎新發(fā)102例,兩周罹患率6.4%。為真實(shí)地反映睢縣5歲以下兒童秋冬季急性胃腸炎發(fā)病水平,根據(jù)睢縣各年齡組實(shí)際人數(shù)及比例,對兩周罹患率進(jìn)行校正,校正后急性胃腸炎兩周罹患率為10.4%。不同年齡組罹患率隨年齡增長呈下降趨勢,2歲及以上男童、女童的兩周罹患率較接近,2歲以下年齡組男孩兩周罹患率大于女孩。2.本次調(diào)查近3個月急性胃腸炎病例260例,出現(xiàn)腹瀉癥狀221例(占85%),出現(xiàn)嘔吐癥狀103例(占39.6%),出現(xiàn)發(fā)熱癥狀64例(占24.6%);其中,僅腹瀉的病例157例(占60.4%),僅嘔吐的病例39例(占15.0%),腹瀉和嘔吐癥狀均發(fā)生的有64例(占24.6%)。發(fā)熱癥狀在僅腹瀉、僅嘔吐、腹瀉且嘔吐的病例中分布不一致,不同類型病例在不同年齡組中分布不一致。3.5歲以下兒童急性胃腸炎病程平均為2.92天,0～1歲兒童病程平均持續(xù)3.94天,2～4歲兒童病程平均持續(xù)2.19天。4.急性胃腸炎病例腹瀉癥狀平均持續(xù)3.19天,嘔吐平均持續(xù)1.70天,腹瀉癥狀通常比嘔吐持續(xù)時間更長;0～1歲兒童病程平均比2～4歲兒童多持續(xù)一天半,腹瀉和嘔吐24h最多發(fā)作次數(shù)均比2～4歲多,間接反映病情更為嚴(yán)重。5.調(diào)查的260例急性腸胃炎病例中,就診者194例,就診率74.6%,其中,住院6例,住院率2.3%,就診率無性別差異,低年齡組就診率高于高年齡組。由于基層衛(wèi)生機(jī)構(gòu)看病較為便捷、便宜,就診者中有145例(占74.8%)首診選擇村衛(wèi)生室或個體診所,所調(diào)查的急性胃腸炎病例在就診過程中,醫(yī)療機(jī)構(gòu)采取的治療措施以吃藥為主(占70.1%)。6.本次調(diào)查無死亡病例,損失壽命年(YLLs)為0,所以本次調(diào)查的DALYs=YLDs。河南睢縣72507名5歲以下兒童的秋冬季急性胃腸炎年化疾病負(fù)擔(dān)為219.92DALYs,80.3%的DALY損失集中于0～1歲組。河南睢縣的各年齡組DALYs呈現(xiàn)隨年齡增長而下降趨勢;不同年齡組DALYs差別較大。其中,0歲組最高,其DALY損失占5歲以下兒童的43.9%;1歲組DALY損失僅次于0歲組,占36.4%;2歲、3歲、4歲組DALY損失相對較少,三個年齡組合計43.40DALYs(占19.7%)。7.5歲以下兒童秋冬季急性胃腸炎病例的樣本例均經(jīng)濟(jì)負(fù)擔(dān)261.72元,經(jīng)濟(jì)負(fù)擔(dān)與年齡呈負(fù)相關(guān),住院病例經(jīng)濟(jì)負(fù)擔(dān)均顯著高于其他人群,是門診病例的10倍以上,是未就診病例的50倍以上。不同癥狀病例類型的例均經(jīng)濟(jì)負(fù)擔(dān),腹瀉且嘔吐病例明顯較僅嘔吐和僅腹瀉病例高,但僅嘔吐病例和僅腹瀉病例的經(jīng)濟(jì)負(fù)擔(dān)無差異。8.經(jīng)睢縣實(shí)際人數(shù)和發(fā)病率校正后的5歲以下兒童例均經(jīng)濟(jì)負(fù)擔(dān)為304.71元,校正后兩歲以下兒童(0～1歲組)例均經(jīng)濟(jì)負(fù)擔(dān)達(dá)363.65元。估計河南睢縣5歲以下兒童一個季度(3個月)急性胃腸炎發(fā)病48540人次,5歲以下兒童急性胃腸炎一個季度(3個月)給河南睢縣帶來的經(jīng)濟(jì)負(fù)擔(dān)總額達(dá)1479.06萬元,占睢縣季度國民生產(chǎn)總值的4.35‰;經(jīng)濟(jì)負(fù)擔(dān)主要集中于0～1歲組,僅2歲以下兒童急性胃腸炎經(jīng)濟(jì)負(fù)擔(dān)就占睢縣季度國民生產(chǎn)總值的3.72‰。結(jié)論:該縣5歲以下兒童秋冬季急性胃腸炎疾病負(fù)擔(dān)較重,其發(fā)病率較高,且隨年齡增長而下降;DALYs同樣呈現(xiàn)隨年齡增長而下降的趨勢,絕大部分DALYs集中于2歲以下兒童;年齡與經(jīng)濟(jì)負(fù)擔(dān)呈負(fù)相關(guān),經(jīng)濟(jì)負(fù)擔(dān)主要集中0-1歲年齡組。
[Abstract]:Objective: to understand the epidemic situation of 1., the local autumn season for acute gastroenteritis in children etiology characteristics, influencing factors and treatment behavior evaluation of local.2. in autumn and winter for acute gastroenteritis in children DALYs and economic burden, and to analyze the epidemic situation of different age groups and different types of symptoms were the incidence, treatment and disease burden differences. Methods: 1. through literature statistical yearbook, government reports, official statistics, the collection of local children under the age of 5 the total number of children under the age of 5, the number of age distribution, local per capita GDP and other basic information. By asking the doctor to fill in the questionnaire to understand the local medical institutions, medical institutions and related cases of diarrhea children consulting room basic information and treatment. All 20 a random sample of community resident children under the age of 5, as the research object of nano.2. in December 2016 in Henan Suixian to carry out field investigation, using a unified questionnaire into The household survey. The main contents include family and personal basic information, within 3 months of the last time the incidence data of acute gastroenteritis (symptoms, duration), treatment (treatment rate, hospitalization rate, hospital stay, etc.), behavior, coping style, treatment measures, medical expenses, medical the cost and working time, influence factors of acute gastroenteritis (pathway information of other diseases, health habits, cultural factors, etc.) using.3. EpiData3.1 to establish a database, data review and logical examination. Using Excel2013 and SPSS20.0 data collection and analysis, the basic characteristics of the survey population, the epidemic characteristics of acute gastroenteritis, treatment behavior and characteristics, economic burden such as descriptive analysis, the relevant factors are chi square test, ANOVA, rank sum test, the test level of 0.05. by two weeks of their prevalence, disability adjusted life years (DALY), direct economic The burden and indirect economic burden indicators reflect the disease burden of acute gastroenteritis. Results: 1. of the survey respondents 1582 effective, burden of disease data in 260 subjects, 3 months in a recent onset of acute gastroenteritis and medical treatment. Within two weeks, 102 new cases of acute gastroenteritis, two week prevalence rate is 6.4%. reflect the Suixian children under the age of 5 in autumn and winter incidence rate of acute gastroenteritis in all age groups, according to the Suixian actual number and proportion of incidence of two weeks corrected after correction of acute gastroenteritis in two week prevalence rate of 10.4%. in different age group prevalence rate decreased with age, and over 2 years old boy, two weeks the girls attack rate is close to that of 2 age groups of two week prevalence rate is greater than the boy girl.2. the survey of nearly 3 months of acute gastroenteritis in 260 cases, 221 cases of diarrhea symptoms (85%), vomiting (103 cases accounted for 39.6 %), fever symptoms in 64 cases (24.6%); among them, only 157 cases of diarrhea (60.4%), only 39 cases of vomiting (15%), diarrhea and vomiting were occurred in 64 cases (24.6%). The symptoms of fever in only only diarrhea, vomiting, diarrhea disease and the distribution of vomiting is not the same, different types of distribution of cases in different age groups of children under the age of.3.5 is not consistent with acute gastroenteritis disease for an average of 2.92 days, the duration of children aged 0~1 years in average duration of 3.94 days, the course of 2~4 year old children for an average of 2.19 days.4. cases of acute gastroenteritis diarrhea symptoms lasted an average of 3.19 days, the average duration of 1.70 days of vomiting the symptoms of diarrhea, vomiting usually lasts longer than the average duration of 0~1 year old children; children aged 2~4 to last more than a day and a half, diarrhea and vomiting episodes are the most 24h ratio of more than 2~4 years old, indirectly reflects the more severe disease.5. investigation of 260 cases of acute gastroenteritis cases In 194 cases, treatment, treatment rate of 74.6%, among them, 6 cases of hospitalization, hospitalization rate 2.3%, treatment rate of no gender differences, the low age group were higher than the high age group. The rate of primary health institutions to see a doctor is more convenient, cheap, patients in 145 cases (74.8%) attending the first choice of village clinics or individual clinic survey of acute gastroenteritis cases in the treatment process, the medical institutions take treatment measures based on medication (70.1%).6. in this survey, no deaths, years of life lost (YLLs) was 0, so this investigation DALYs=YLDs. Henan Suixian 72507 children under the age of 5 years of acute gastroenteritis in autumn and winter the burden of disease is 219.92DALYs, 80.3% DALY loss concentrated in the 0~1 age group. Each age group DALYs Henan Suixian show downward trend with age; different age groups DALYs different. Among them, the highest 0 years old group, the DALY loss of children under the age of 5 accounted for 43.9%; 1 The age group of DALY loss after 0 years group, accounting for 36.4%; 2 years old, 3 years old, 4 years old group DALY relatively small loss in three age groups of 43.40DALYs (19.7%) sample of children under the age of autumn and winter.7.5 acute gastroenteritis patients economic burden of 261.72 yuan, the economic burden was negatively correlated with age, hospitalization the economic burden of patients were significantly higher than that of the rest of the population, is 10 times more than the case, is 50 times more than the patients. Different types of cases were diarrhea and vomiting patients economic burden, obviously only vomiting and diarrhea were only high, but only vomiting cases and only diarrhea cases of economic burden and no difference in.8. the actual number of Suixian and the incidence of the corrected cases of children under 5 years are the economic burden of 304.71 yuan, after correction for children under two years of age (0~1 years old) were the economic burden of 363.65 yuan. Henan Suixian children under the age of 5 in a quarter (3 months) of acute The incidence of gastroenteritis in children under the age of 5 48540 people, a quarter of acute gastroenteritis (3 months) the total economic burden brought to Henan in Suixian amounted to 14 million 790 thousand and 600 yuan, accounting for a quarter of Suixian GDP of 4.35 per thousand; economic burden is mainly concentrated in the age group of 0~1, only 2 children under the age of acute gastroenteritis accounted for a quarter of Suixian economic burden 3.72 of the gross national product%. Conclusion: children under the age of 5 in the county of autumn and winter disease acute gastroenteritis burden is heavy, the disease incidence rate is high, and decreased with age; DALYs also decreases with age increasing, most of the DALYs focus on children under 2 years of age; age was negatively correlated with economic burden the economic burden, mainly at the age of 0-1.

【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.1;R181.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李巧;李永武;張帆;易聰;王基鴻;;5歲以下兒童腹瀉與家庭衛(wèi)生行為和衛(wèi)生條件的關(guān)系[J];環(huán)境與健康雜志;2016年07期

2 羅冀南;;廣東省2012—2015年手足口病流行現(xiàn)狀分析及其治療對策研究[J];齊齊哈爾醫(yī)學(xué)院學(xué)報;2016年18期

3 賈蕾;劉瀟瀟;李洪軍;梁妍;高志勇;王全意;;北京市5歲以下兒童輪狀病毒腹瀉經(jīng)濟(jì)負(fù)擔(dān)研究[J];中國疫苗和免疫;2015年05期

4 宋玉芳;吳方敏;李克;張瓊;濮培龍;徐志燕;;長興縣5歲以下兒童感染性腹瀉流行特征分析[J];浙江預(yù)防醫(yī)學(xué);2015年10期

5 郭丹丹;李洪軍;劉瀟瀟;梁研;高志勇;王全意;賈蕾;;北京市5歲以下兒童輕、重型腹瀉相關(guān)因素分析[J];中華疾病控制雜志;2015年08期

6 夏勝利;張玉凱;謝志強(qiáng);陳豪敏;冉陸;朱敏;;河南省2007年腹瀉病醫(yī)院病例的疾病負(fù)擔(dān)分析[J];中華流行病學(xué)雜志;2015年08期

7 吳偉;周永柏;丘惠嫻;吳偉晴;王自財;周曙明;;小兒散發(fā)性諾如病毒性腸炎的臨床分析[J];中國婦幼保健;2015年11期

8 鄂靜文;吳麗麗;趙麗梅;朱麗華;;腹瀉患者常見病毒監(jiān)測與疾病負(fù)擔(dān)分析[J];標(biāo)記免疫分析與臨床;2014年03期

9 劉海霞;劉新鳳;劉東鵬;張靜;孟蕾;;5歲以下兒童輪狀病毒腹瀉流行特征和經(jīng)濟(jì)負(fù)擔(dān)評價分析[J];中國初級衛(wèi)生保健;2014年06期

10 龍聰;祝成亮;楊章元;雷鴻斌;明亮;;腹瀉患兒輪狀病毒感染分析[J];中華醫(yī)院感染學(xué)雜志;2014年07期

相關(guān)碩士學(xué)位論文 前1條

1 楊建軍;甘肅省腹瀉病流行特征和經(jīng)濟(jì)負(fù)擔(dān)研究[D];中國疾病預(yù)防控制中心;2008年

，

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