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目的了解脑卒中造成农村人口的疾病负担,为促进我国脑卒中疾病负担的研究及今后卫生资源的合理配置提供参考;同时简化失能调整生命年(DALY)运算中失能的评估方式。方法整群抽样,采用自行设计的问卷,入户调查,调查脑卒中全部现患患者164人。问卷内容主要包括一般情况和失能的评估。结果汉中市农村脑卒中患者DALY为598.88 a,其中因死亡损失了471.05 a,失能损失了127.83 a,患者平均损失3.65个DALYs,汉中市农村人口每千人损失8.0个DALYs;以70~74岁年龄组损失最多;失能损失中,以65~69岁年龄组为最多,死亡的损失中,以55~59岁年龄组为最多,按性别分组后,男性损失343.26个DALYs,女性损失255.62个DALYs,分别占总损失的57.3%和42.7%。男性以55~59岁年龄组损失最多,女性以65~69岁年龄组损失最多。40~44岁年龄组的每个患者平均损失数最多,按残疾期限分组后,残疾1~4 a的损失DALY最多。将患者按照失能程度分组,存活的患者中,失能程度0.01~0.10的人数最多,失能程度0.51~0.60的DALY最多,失能程度0.51~0.60的人均DALY最多,达2.78个DALYs。结论脑卒中对我国造成的疾病负担高于发达国家,一方面可能由于我国脑卒中发病率和死亡率比较高,另一方面可能由于DALY本身的缺陷导致我国疾病负担的高估。
Objective To understand the disease burden caused by stroke in rural population and to provide reference for promoting the research on the burden of stroke in our country and the rational allocation of health resources in the future.Meanwhile, to simplify the evaluation method of disability in disability-adjusted life years (DALY). Methods Cluster sampling, using self-designed questionnaires, household surveys to investigate all the patients with stroke 164 people. The questionnaire mainly includes the assessment of the general situation and disability. Results The DALY of rural stroke patients in Hanzhong City was 598.88 years, of which 471.05 years were lost due to death, 127.83 years due to incapacitation, and 3.65 DALYs were lost in rural areas. Hanzhong rural population lost 8.0 DALYs per 1000 people. In the age group, the loss was the most. Among the loss-of-function losses, the highest was in the 65-69 age group and the highest was in the 55-59 age group. According to sex, the male lost 343.26 DALYs and the female lost 255.62 DALYs, accounting for 57.3% and 42.7% of the total losses, respectively. Men in the 55 to 59 age group lost the most, women in the 65 to 69 age group lost the most. The average loss per patient in the 40- to 44-year age group was the highest, with DALY losses of 1 to 4 years after disability grouped by disability. According to the degree of disability, patients were grouped according to the degree of disability. Among the patients who survived, the number of persons with disability ranged from 0.01 to 0.10, and the disability ranged from 0.51 to 0.60, up to 2.70 DALYs per capita with disability 0.51-0.6. Conclusions Stroke burden on our country is higher than that of developed countries. On the one hand, it may be due to the high incidence of stroke and mortality in our country. On the other hand, the burden of disease in our country may be overestimated due to the defect of DALY itself.