| Objective:Based on the information of the medical records of 12 sentinel surveillance hospitals in Wuwei City from 1995 to 2016,the characteristics,distribution and incidence trends of patients with cholelithiasis were analyzed through the analysis of basic medical records information.To explore the spatial distribution differences and trends of cholelithiasis in Wuwei City,and to identify the high incidence areas of local cholelithiasis,and provide a theoretical basis for the residents to carry out corresponding health prevention measures.Methods:1.Collection,entry and analysis of Medical Record Information:Collected the records of cholelithiasis from 12 secondary level A and above sentinel surveillance hospitals in in Liangzhou District,Gulang County,Minqin County and Tianzhu County of Wuwei City from 1995 to 2016(the medical records are clear,the records are detailed,there is no forgery,and the content is not true.And the patient needs to be a resident of Wuwei City);For the information needed by the institute(age,gender,ethnicity,occupation,address,surgery history,family history,length of hospital stay,expenses,etc.),used Equary software to collect and export data using Excel2016 for storage edited.The data were processed using SPSS22.0 software.The t-test was used for the measurement data,and the?~2 test was used for the count data.Size of a test?=0.05.2.Spatial Epidemiology Research:The use of the Geographic Information System(GIS)to visualize digital information data.Used Wuwei City electronic map as the basic map layer,added longitude,dimension coordinate value,township administrative code,drawing the spatial distribution map of cholelithiasis disease in Wuwei City;Used SaTScan software for spatial scanning,detecting morbidity hotspots,according to log likelihood ratio(Log Likehood Ratio,LLR)to judge the strength of aggregation,according to the P value to determine whether the difference is statistically significant,size of a test?=0.05.3.Jionpoint Trend Research:The data was edited by Excel2016,the 2010 national population was taken as the standard population.The Annual Percent Change(APC)and Average Annual Percent Change(AAPC)of the incidence of cholelithiasis were calculated using the Joinpoint software.Trend analysis was performed by comparing APC and AAPC worthy of positive and negative.Results:1.Distribution Characteristics of Patients with Cholelithiasis in Wuwei City(1)Basic characteristics of patients:A total of 32,533 patients with cholelithiasis in Wuwei City were included in the study,including 21,942(67.45%)females and 10,591(32.55%)males.The ratio of female patients to male patients was 2.07:1.The average age of the patients was 53.07±14.8 years.(2)Distribution of One Districts and Three Counties:The proportion of female patients in the order of high to low were 3347(71.42%)in Gulang County,2633(69.20%)in Tianzhu County,15070(66.58%)in Liangzhou District,and 766(62.18%)in Minqin County;males from high to low were 466(37.82%)in Minqin County,7563(33.42%)in Liangzhou District,1172(30.80%)in Tianzhu County,and 1390(28.58%)in Gulang County.Among them,the 45-54-year-old group was the age group with the highest proportion of patients in Liangzhou District and Gulang County,and the composition ratio was 5660(25.01%)and 1188(24.43%)respectively.65 years old was the highest age ratio of 346(28.08%)in Minqin County and 981(25.78%)in Tianzhu County;According to the comparison of the composition ratios of patients with different occupational cholelithiasis,it was found that the most occupations of the patients in the four districts are farmers.According to the number of patients,the number of patients from high to low was 2640(69.38%)in Tianzhu County and 3316(68.19%)in Gulang County,637(51.70%)in Minqin County and 9537(42.14%)in Liangzhou District;The most hospitalized season for patients with cholelithiasis in the four districts was winter,Gulang County 1612(33.15%),Minqin County 377(30.60%),Tianzhu County 1142(30.01%),Liangzhou District 6528(28.85%),The above results were statistically significant(P<0.05).2.Joinpoint Regression Analysis of the Incidence of Cholelithiasis in Wuwei City from1995 to 2016(1)Gender:The age-standardized incidence of female cholelithiasis was higher than that of males and the age-standardized incidence of cholelithiasis in men and women showed a continuous upward trend from 1995 to 2016.The male incidence rate increased by 16.5%(95%CI,10.5%-22.7%)per year on average,and the female incidence rate increased by 13.1%(95%CI,9.9%-16.3%)per year(P<0.05).(2)Age:Male cholelithiasis in Wuwei City was high in people over 65 years old,females were high in 55-64 years old,64-year-old or older;males in 25-34 years old had a single upward trend in the incidence of cholelithiasis from 1995 to 2016,which was increased 18.8%(95%CI,16.5%-21.2%),the incidence of female cholelithiasis increased by 12.3%(95%CI,7.2%-17.6%)year in the group;The incidence of cholelithiasis in men aged 35-44 years increased by 14.3%(95%CI,6.3%-22.8%)annually,and the average annual increase of women was 11.5%(95%CI,6.5%-26.6%);The incidence of males in the 45-54 age group from 1995 to 2016 the rate was a single upward trend with an average annual increase of 18.6%(95%CI,16.6%-20.6%).The average annual growth rate of women was 13.1%(95%CI,8.3%-18.0%);the incidence of men in the 55-64 age group increased by 14.4%(95%CI,5.3%-24.3%)annually from1995 to 2016,and the average annual increase of women was 11.4%(95%CI,4.8%-18.4%);The trend of male morbidity in the 65-year-old group increased by 24.3%(95%CI,18.1%-30.8%)annually.Both increased by 21.8%(95%CI,18.4%-25.3%)(P<0.05).3.Spatial Distribution Characteristics and Spatial Aggregation of Cholelithiasis in Wuwei City(1)The Spatial Distribution of Incidence of Cholelithiasis in Wuwei City from 1995to 2016:The towns with the highest incidence of local cholelithiasis were Hongshagang Town Minqin County,Dizhi Xincun Sub-district Office Liangzhou District,Anyuan Town Tianzhu County.Town(252.68/100,000,155.04/100,000,147.45/100,000)from1995 to 1997;The highest incidence rate in 1998 was Qingyuan Town,Liangzhou District(85.15/100,000);In 1999,the township with the highest incidence of cholelithiasis in Wuwei City was Selalong Town,Tianzhu country(332.23/100,000);From 2000 to 2010,the towns and towns with the highest incidence of local cholelithiasis were Hongshagang Town,Minqin County(189.51/100,000,154.94/100,000,385.60/100,000,518.81/100,000,523.22/100,000,593.67/100,000,798.93/100,000,940.23/100,000,542.37/100,000,342.00/100,000,552.10/100000);2011 Songshan Town,Tianzhu County,the town with the highest incidence of cholelithiasis in that year(496.69/100,000).From 2012 to 2016,Hongshagang Town,once again became the township with the highest incidence rate(1013.51/100,000,1711.03/100,000,2611.53/100,000,1016.52/100,000,610.69/100,000),in which the incidence of cholelithiasis in Hongshagang Town,Minqin County in 2014 was the highest in past 22 years.(2)1995~2016 Spatial cluster of Incidence of Cholelithiasis in Wuwei City:Cluster area 1 was distributed in Liangzhou District,with a total of 14 townships,with a total population of 333,706,LLR=3606.37,and the number of observed cases between 2011and 2016 was 5792 people,the average incidence rate was 310.70/100,000,the risk degree was 4.24,the radius of the aggregation area was 10.46Km;The cluster area 2covers 1 township of Gulang County and 14 townships of Tianzhu County.The total population in the area was 167,737 people,LLR=1222.20,observed 2,372 people between 2012 and 2016,with an average incidence rate of 280.10/100,000,a risk factor of 3.48,and a radius of 42.15 Km,which was the largest coverage area.Cluster area 3includes 9 townships in Liangzhou District and 6 townships in Gulang County.The population in the area was 346,655 people,LLR=1157.04.In the region from 2013 to2016,the number of observed cases was 3398,and the average incidence rate was213.60/100,000,the degree of danger was 2.69,which was a relatively dangerous area with a radius of 22.28Km;Cluster area 4 was Hongshagang Town,Minqin County,with a total population of 1386,LLR=186.78,during 2003 to 2015,the number of cases observed was 138 The average incidence rate of 802.10/100,000,degree of risk was9.49,the highest risk of cluster area.Conclusions:1.The number of women with cholelithiasis in Wuwei City was higher than that of man.The incidence trend analysis showed that the incidence of cholelithiasis in both men and women in Wuwei City increased from 1995 to 2016.2.Males over 65 years old,females 55 years old and older are the high-incidence age of local cholelithiasis.The incidence of cholelithiasis in all age groups showed an increasing trend from 1995 to 2016.3.There was a significant change in the spatial distribution of cholelithiasis in Wuwei City from 1995 to 2016.From 1995 to 2003,the local high incidence of cholelithiasis showed sporadic distribution.As time went on until 2016,the local high incidence of cholelithiasis was distributed from east to west.The distribution of local cholelithiasis was concentrated in hot spots.Liangzhou District,Gulang County and Tianzhu County Junction,Liangzhou District and Gulang County Junction,Hongshagang Town,Minqin County.Among them,the gathering area of Liangzhou urban area was the strongest,and the risk of the disease is the highest in Hongshagang Town of Minqin County. |
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