Email Alert | RSS

北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (5): 952-956. doi: 10.19723/j.issn.1671-167X.2021.05.024

• 论著 • 上一篇    下一篇

COVID-19疫情前后北京市某综合医院儿科门诊患儿就诊量变化分析

孟洪1,季丽娜1,△(),黄静1,2,晁爽1,周佳雯3,李学军1,尹小梅1,樊丽容1   

  1. 1.清华大学附属北京清华长庚医院儿科,清华大学临床医学院, 北京 102218
    2.首都医科大学附属北京儿童医院中医科,国家儿童医学中心, 北京 100045
    3.清华大学附属北京清华长庚医院信息管理部, 清华大学临床医学院, 北京 102218
  • 收稿日期:2021-03-11 出版日期:2021-10-18 发布日期:2021-10-11
  • 通讯作者: 季丽娜 E-mail:jlna01103@btch.edu.cn

Analysis of the changes and characteristics of pediatric outpatient visits in a general hospital in Beijing before and after the COVID-19 pandemic

MENG Hong1,JI Li-na1,△(),HUANG Jing1,2,CHAO Shuang1,ZHOU Jia-wen3,LI Xue-jun1,YIN Xiao-mei1,FAN Li-rong1   

  1. 1. Department of Pediatrics,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University,School of Clinical Medicine of Tsinghua University, Beijing 102218, China
    2. Department of Traditional Chinese Medicine, Beijing Children’s Hospital affiliated to Capital Medical University & National Center for Children’s health, Beijing 100045, China
    3. Department of Information Management, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University,School of Clinical Medicine of Tsinghua University, Beijing, 102218, China
  • Received:2021-03-11 Online:2021-10-18 Published:2021-10-11
  • Contact: Li-na JI E-mail:jlna01103@btch.edu.cn

RICH HTML

   

PDF (PC)

摘要：

目的: 分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情前后北京市某综合医院儿科门诊患儿就诊量变化及其特点。方法: 选择2018年1月1日至2020年12月31日在北京清华长庚医院信息系统(hospital information system, HIS)中有挂号登记的年龄0~16岁的儿科门诊患儿病例资料进行回顾,分析疫情前后就诊量,重点是呼吸道感染(包括流感)就诊量的变化及其与年龄、季度分布的关系。结果: (1)2018年和2019年的门诊量中呼吸道感染均为主要就诊原因(分别占60.6%和60.5%), 而2020年的门诊患者中以非呼吸道感染为主,呼吸道感染仅占47.4%。2020年的呼吸道感染疾病、呼吸道传染病尤其是流感的就诊量较2018年和2019年均显著下降(P<0.05);(2)每年呼吸道感染就诊者中均以婴幼儿占比最高,学龄期儿童最少(P<0.05), 且均为第四季度最高。不同于2018年和2019年,2020年第二季度呼吸道感染就诊量显著下降,年内各季度间比较差异有统计学意义(P<0.05);(3)每年呼吸道传染病均以流感为主,且均为第一季度就诊量最高, 与年内其他季度相比差异有统计学意义(P<0.05)。不同于2018和2019年全年均有散发流感病例,2020年的流感病例全部发生在第一季度,且99%集中在1月份。结论: COVID-19疫情后北京某综合医院儿科门诊呼吸道感染尤其流感的就诊量较疫情前显著下降,这与疫情后人们的生活方式和个人防护密不可分。建议在冬春季加强对儿童呼吸道感染及流感预防的健康宣教,促进养成良好的呼吸道和手卫生习惯。

关键词: 综合医院, 儿科门诊, COVID-19, 呼吸道感染, 流感

Abstract:

Objective: To analyze the changes and characteristics of pediatric outpatient visits in a general hospital before and after the coronavirus disease (COVID-19) epidemic. Methods: Based on the registration data of pediatric outpatient visits in the information system (HIS)of Beijing Tsinghua Changgung Hospital, from January 1 2018 to December 31 2020, aged 0 to 16 years,we analyzed the changes of outpatient visits before and after the epidemic, focusing on respiratory infection including influenza. The relationship between the outpatient visits and age and quarterly distribution were also studied. Results: (1)Respiratory infection accounted for the majority of outpatient visits in 2018 and 2019 (60.6% and 60.5%, respectively). Non-respiratory infection accounted for the main proportion of outpatient visits in 2020, while respiratory infection accounted for only 47.4%. Annual respiratory infection visits, respiratory infectious diseases visits especially influenza visits all decreased significantly in 2020 compared with that in 2018 and 2019 (P<0.05). (2)Respiratory infection visits were highest in the infant group, lowest in the school age group (P<0.05) and highest in the fourth quarter each year. It decreased significantly in the second quarter of 2020 with statistical significance when compared with the other quarters of 2020(P<0.05). (3)Influenza accounted for the highest proportion of respiratory infectious diseases visits in each year. It was highest in first quarter, which was significantly different from the other quarters of the year (P<0.05). There were different distributions of influenza visits throughout 2018 and 2019, while it was only distributed in the first quarter and 99% in January in 2020. Conclusion: The respiratory infection and influenza visits have decreased significantly in our pediatric outpatient department after the COVID-19 epidemic,which is considered closely related to the lifestyle and personal protection after the epidemic. It is recommended that health education on respiratory infection and influenza prevention should be strengthened, especially in winter and spring, to promote the development of good respiratory and hand hygiene habits.

Key words: General Hospital, Pediatric outpatient, COVID-19, Respiratory infection, Influenza

中图分类号: 

  • R725.1

表1

2018—2020年儿科门诊量"

Items 2018 2019 2020 χ2 P
Total visits 55 263 64 180 34 071
RI visits 33 510 38 821 16 145 1 883 <0.01
RID visits 1 007 1 904 596 174 <0.01
Flu visits 784 1 713 489 244 <0.01

表2

2018—2020年门诊呼吸道感染就诊量的性别和年龄构成"

Items 2018 2019 2020 χ2 P
Gender Male 18 340
(54.7)		 21 184
(54.6)		 8 987
(55.7)		 5.74 0.05
Infant 20 894
(62.4)		 22 859
(58.9)		 9 211
(57.1)		 154 <0.01
Age groups Preschool 9 657
(28.8)		 11 857
(30.5)		 4 584
(28.4)		 36 <0.01
School age 2 959
(8.8)		 4 105
(10.6)		 2 350
(14.5)		 376 <0.01

表3

2018—2020年呼吸道感染就诊量的季度分布"

Year First quarter Second quarter Third quarter Fourth quarter χ2 P
2018 7 680 (22.9) 7 436 (22.2) 7 675 (22.9) 10 719 (32) 445 <0.01
2019 9 083 (23.4) 9 197 (23.7) 8 897 (22.9) 11 644 (30) 182 <0.01
2020 3 632 (22.5) 1 386 (8.6) 3 570 (22.1) 7 557 (46.8) 2 574 <0.01

表4

2018—2020年传染性疾病及流感就诊量的季度分布"

Items Year First quarter Second quarter Third quarter Fourth quarter χ2 P
RID
visits		 2018 710 (70.5) 50 (5) 123 (12.2) 124 (12.3) 1 342 <0.01
2019 833 (43.7) 641 (33.7) 76 (4.0) 354 (18.6) 838 <0.01
2020 506 (84.9) 20 (3.4) 16 (2.7) 54 (9) 1 384 <0.01
Flu
visits		 2018 696 (88.8) 3 (0.4) 0 (0) 85 (10.8) 1 987 <0.01
2019 815 (47.6) 584 (34.1) 3 (0.2) 311 (18.1) 1 015 <0.01
2020 489 (100) 0 (0) 0 (0) 0 (0) 1 737 <0.01
[1] Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster [J]. Lancet, 2020, 395(10223):514-523.
doi: 10.1016/S0140-6736(20)30154-9
[2] Ji LN, Chao S, Wang YJ, et al. Clinical features of pediatric patients with COVID-19: a report of two family cluster cases [J]. World J Pediatr, 2020, 16(3):267-270.
doi: 10.1007/s12519-020-00356-2
[3] Wei M, Yuan J, Liu Y, et al. Novel coronavirus infection in hospitalized infants under 1 year of age in China [J]. JAMA, 2020, 323(13):1313-1314.
doi: 10.1001/jama.2020.2131
[4] 国家呼吸系统疾病临床医学研究中心. 中华医学会儿科学分会呼吸学组. 儿童流感诊断与治疗专家共识(2020年版) [J]. 中华实用儿科临床杂志, 2020, 35(18):1281-1288.
[5] Song P, Theodoratou E, Li X, et al. Causes of death in children younger than five years in China in 2015: an updated analysis [J]. J Glob Health, 2016, 6(2):20802.
doi: 10.7189/jogh.06.020802
[6] 秦强, 申昆玲. 儿童重症流感发病机制 [J]. 中华实用儿科临床杂志, 2019, 34(2):98-101.
[7] Gaglani MJ. Editorial commentary: school-located influenza vaccination: why worth the effort [J]. Clin Infect Dis, 2014, 59(3):333-335.
doi: 10.1093/cid/ciu344
[8] Piedra PA, Gaglani MJ, Kozinetz CA, et al. Herd immunity in adults against influenza-related illnesses with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in children [J]. Vaccine, 2005, 23(13):1540-1548.
pmid: 15694506
[9] 邢燕, 张娟, 韩彤妍, 等. 新型冠状病毒感染肺炎疫情下综合医院儿科防控方式探索 [J]. 北京大学学报(医学版), 2020, 52(3):410-413.
[10] 秦强, 谢正德, 申昆玲. 美国感染病协会关于季节性流感诊断、治疗、药物预防和机构内流感暴发应对措施2018指南更新儿童相关内容解读. 中华实用儿科临床杂志, 2019, 34(2):87-90.
[11] 王芳, 钱渊, 邓洁, 等. 2004至2017年北京地区儿童流行性感冒样病例中甲型流行性感冒的流行特征 [J]. 中华儿科杂志, 2018, 56(6):429-434.
[12] Shen KL, Yang Y. Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue [J]. World J Pediatr, 2020, 16(3):219-221.
doi: 10.1007/s12519-020-00344-6
[1] 刘光奇,庞元捷,吴疆,吕敏,于孟轲,李雨橦,黄旸木. 2013—2019年流感季北京市住院老年人流感疫苗接种趋势分析[J]. 北京大学学报（医学版）, 2022, 54(3): 505-510.
[2] 李佳,徐钰,王优雅,高占成. 老年流感肺炎的临床特征及D-二聚体与疾病严重程度的相关性[J]. 北京大学学报（医学版）, 2022, 54(1): 153-160.
[3] 王秋,郭金玉,孙红,王泠,应菊素,刘慧鑫. 抗击新型冠状病毒肺炎一线护理人员防护暴露风险事件调查[J]. 北京大学学报（医学版）, 2020, 52(4): 711-714.
[4] 邢燕,张娟,韩彤妍,李在玲,李蕊,童笑梅. 新型冠状病毒感染肺炎疫情下综合医院儿科防控方式探索[J]. 北京大学学报（医学版）, 2020, 52(3): 410-413.
[5] 李纯青, 王东信, 程彤, 郑雪宜. 近期上呼吸道感染史对儿童围术期呼吸系统不良事件的影响:前瞻性队列研究[J]. 北京大学学报(医学版), 2017, 49(5): 814-818.
[6] 李志霞，武珊珊，杨智荣，詹思延，孙凤. 胰高血糖素样肽1受体激动剂类降糖药致2型糖尿病患者鼻咽炎和上呼吸道感染的网状meta分析[J]. 北京大学学报(医学版), 2016, 48(3): 454-459.
[7] 武轶群, 席韩旭, 张洋, 孙可欣, 周子君, 胡永华. 北京市三级综合医院急性上呼吸道感染患者抗菌药使用情况分析[J]. 北京大学学报（医学版）, 2014, 46(3): 435-439.
[8] 张效云，李琦，张颖骞. 中和白细胞介素-17加重小鼠衣原体呼吸道感染[J]. 北京大学学报（医学版）, 2013, 45(4): 613-.
[9] 王富华, 谢铮, 吕敏, 邓瑛, 张拓红. 北京户籍老人免费流感疫苗接种情况及城乡差异分析[J]. 北京大学学报（医学版）, 2013, 45(03): 432-436.
[10] 张代涛, 杨鹏, 张奕, 张莉, 彭晓旻, 石伟先, 卢桂兰, 梁慧洁, 刘医萌, 刘民, 王全意. EARS在北京市流感大流行预警中的应用[J]. 北京大学学报（医学版）, 2012, 44(3): 412-415.
[11] 李宏亮*, 李保顺*, 杜红艳, 朱曦, 郭利民, 孙凌波, 张喆, 幺改琦 . 体外膜肺氧合治疗甲型H1N1流感病毒感染所致急性呼吸窘迫综合征[J]. 北京大学学报（医学版）, 2010, 42(6): 654-656.
[12] 张效云, 李蓟龙, 董明纲, 高丽芬, 钟光明. 白介素-17 在沙眼衣原体呼吸道感染中的早期产生可提高局部白介素-6和巨噬细胞炎性蛋白-2的表达[J]. 北京大学学报（医学版）, 2010, 42(5): 509-513.
[13] 何耀鑫, 高子芬, 陆敏, 隋官杰, 冉光伟, 曹彬, 王辰, 陈洁, 赵希顺. 人感染甲型H1N1流感病毒重症死亡病例的病理学观察[J]. 北京大学学报（医学版）, 2010, 42(2): 137-139.
[14] 牟向东, 王广发, 阙呈立, 李桂莲. H3N2型人流行性感冒合并金黄色葡萄球菌败血症及金黄色葡萄球菌肺炎1例[J]. 北京大学学报（医学版）, 2007, 39(6): 663-665.
[15] 周洪柱, 王瑞儒, 宋纯理, 张永珍, 敖英芳, 陈仲强. 19例医务人员感染SARS发生原因和对策的初步分析[J]. 北京大学学报（医学版）, 2003, 35(z1): 55-58.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部